后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿21例分析

Retroperitoneoscopic renal pedicle lymphatic ligation in the treatment of chyluria

目的探讨后腹腔镜下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 21例患者均行后腹腔镜肾蒂淋巴管结扎术。结果 21例患者手术均成功,平均手术时间(93.52±38.50)min,术中出血量平均(56.74±37.02)ml,术后平均(2.12±0.43)d下床活动,术后平均住院(7.12±1.03)d,未见明显的外科并发症。患者出院时尿液均清亮,尿乳糜试验全部阴性。随访2～24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可靠,具有微创、出血少、住院时间短、恢复快等特点,淋巴管结扎更加完全。

Objective To evaluate the method of surgical technique and clinical effect of retroperitoneoscopic renal pedicle lymphatic ligation in the treatment of chyluria.Methods 21 cases of chyluria were selected for retroperitoneoscopic renal pedicle lymphatic ligation.Results All cases were successfully treated with retroperitoneoscopic management.The average operation duration was（93.52±38.50）min and the average blood loss was（56.74±37.02）ml.The average out of bed activity was（2.12±0.43）days and the average hospital stay after operation were（7.12±1.03）days.No complications occurred.The urine of all patients was clear when the patients were discharged from the hospital.Chyluria disappeared in all the 21 cases.No recurrence of chyluria was found during the follow-up of 2 months to 24 months.Conclusion Retroperitoneoscopic renal pedicle lymphatic ligation in treatment of chyluria is an ideal surgical procedure and has the advantages of minimal invasion,less blood loss,short hospital stay,rapid recovery and complete lymphatic vessels ligation.