后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿

Experiences in Retroperitoneoscopic Ligation of Renal Lymphatic Vessels for the Treatment of Chyluria

目的探讨后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿的手术方法和临床效果。方法回顾性分析8例单侧乳糜尿患者行后腹腔镜肾蒂淋巴管结扎术治疗的临床资料。结果8例患者均手术成功,平均手术时间82 min,术中平均出血量70 mL,无意外损伤,术后平均住院7.2 d。患者出院时尿液均清亮,8例患者尿乙醚试验全部阴性。随访3～22个月,无复发。结论后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿疗效较好,具有术中出血量少、创伤小、淋巴管结扎彻底、术后住院时间短、恢复快等优点,是目前治疗乳糜尿较理想的手术方式。

Objective To evaluate the surgical technique and clinical efficacy of retroperito-neoscopic ligation of renal lymphatic vessels for the treatment of chyluria. Methods Eight unilateral cases were selected for retroperitoneoscopic ligation of renal lymphatic vessels. Results All cases had been successfully treated with retroperito-neoscopic management. The average operation time was 82 minutes and the average blood loss was 70 mL without unexpected injure. And the average hospital stay after operation was 7.2 days. The urine from all patients was clear when the patients discharged from the hospital. The urine ether tests were total negative. Chyluria disappeared in the 8 unilateral cases. No recurrence of chyluria was found during the follow-up for 3～22 months. Conclusion Retroperitoneoscopic ligation of renal lymphatic vessels for the treatment of chyluria is an effective and efficient surgical procedure and has the advantages of less blood loss, minimal invasion, complete lymphatic vessels ligation, short hospital stay and rapid recovery. So far,it is an ideal surgical procedure for treatment of chyluria.