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治疗乳糜尿的临床疗效。方法:2007年10月～2008年10月收治13例乳糜尿患者,其中男5例,女8例,年龄28～54岁(平均38岁),病史1～15年。乳糜尿来自左侧6例,右侧7例。13例均行后腹腔镜肾蒂淋巴管结扎术。结果:13例手术均取得成功,无一例转开放手术,手术时间60～115 min(平均90 min),术中出血量10～80 ml(平均40 m1),均未输血。13例患者术后当天乳糜尿均消失,未出现并发症。术后平均住院5.5天。随访0.5～1年,仅1例出现对侧复发再次行患侧后腹腔镜肾蒂淋巴管结扎术,其他患者均无乳糜尿症状复发。结论:后腹腔镜肾蒂淋巴管结扎术是一种治疗乳糜尿安全、有效的方法,具有创伤小、并发症少、术后恢复快、复发率低等优点,值得临床推广应用。

Objective;To explore the clinical effect of retroperitoneoscopic renal pedicle lymphatic disconnection in the management of chyluria. Methods： Retrospectively analyzed a total of 13 patients of chyluria treated with retroperitoneo-scopic renal pedicle lymphatic disconnection in our department from October 2007 to October 2008. Of the 13 patients, 5 were male and 8 were female,with an dverage age of 38 years and case history from 1 to 15 years. Chyluria was found on the left in 6 cases, on the right side in 7 cases. All cases had been treated with retro- peritoneoscopic renal pedicle lymphatic disconnection. Results： 13 cases were all successful treated with laparoscopic management, and none was transferred to open suigery. The mean operating time was 90 rain （60-115min）. The mean introperative bleeding was 40 ml （10-80 ml） with no blood transfusion. Chyluria of all patients disappeared on the operation day postperatively. No patients had complication after operation. The mean postoperative hospital stay was 5.5 days： During the follow-up of 0.5 to 1 year, only one case recurred on the opposite side and was treated with laparoscopic management again. No recurrence of chyluria was found in other patients. Conclusions： Retroperitoneoscopic renal pedicle lymphatic disconnection for chyluria is a safe, efficient mehtod, with advantages of mini-invasion , fewer complications , rapid recovery and low recurrence rate, worth to be extended.