后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿

Retroperitoneoscopic renal pedicle lymphatic disconnection for chyluria

目的:探讨后腹腔镜肾蒂淋巴管结扎术在乳糜尿治疗中的临床价值。方法:回顾分析14例后腹腔镜肾蒂淋巴管结扎患者的临床资料,观察手术时间,术中出血量,术后肠功能恢复时间、住院天数、尿液变化,比较手术前后血红蛋白及血白蛋白变化。结果:14例手术全部取得成功,无中转开放,平均手术时间(156.4±68.7)min;术中平均出血量(25.7±14.7)ml;术后平均住院(9.3±2.4)天,术后肠功能恢复时间1～3天。所有患者术后乳糜尿立即消失。术后随访0.5～2.0年,患者尿液清亮,营养状况明显改善;术后半年复查血红蛋白及血白蛋白,均较术前有显著增加。结论:后腹腔镜肾蒂淋巴管结扎术手术疗效肯定,术中出血少,术后恢复快,对患者损伤小,并发症少,是一种安全,有效的治疗方法,有推广运用价值。

To observe the clinical value of retroperitoneoseopic renal pedicle lymphatic disconnection in the management of chyluria. Methods：Retrograde analysis the clinical data of 14 patients undertaken retroperitoneoscopic renal pedicle lymphatic disconnection, which includes the operation time, blood [ossing, recovery time of gastrointestinal function, hospitalizing time after surgery and the change of urine, hemoglobin and albumin. Results：Operation were succeeded in all patients, no conversion oecured. Mean operation time; （156.4± 68.7） mi- nutes, blood lossing： （25.7±14.7 ） ml, hospitalizing time： （9.3 ±2.4） days, recovery time of gastrointestinal function： 1-3 days. Chyluria disappeared immedialy after operation in all patients, nutritional state changed greatly after surgery, hemoglobin and albumin increased significantly in following up period ,of 0.5-2.0 years. Conclusions：Retroperitoneoseopie renal pedicle lymphatic disconnection for chyluria was a effective and efficienl method in the management of chyluria. And its also safe , minimal invasive , less blood lossing, fewer complications , short hospital stay , and rapid recovery of gastrointestinal function.