双侧乳糜尿腹腔镜治疗

Bilateral laparoscopic treatment of chyluria

目的:探讨腹腔镜下肾蒂淋巴管结扎术治疗双侧乳糜尿的手术方法、临床价值以及临床疗效。方法:随机选取本院2007年10月～2009年12月间确诊为双侧乳糜尿的10例患者,对其采用腹腔镜行双侧肾蒂淋巴管结扎术,术中使用超声刀,不放置钛夹,未完全游离肾脏,并对手术的时间、手术疗效、术中并发症、术中出血量、术后功能恢复情况以及住院时间等具体指标进行观察和评定。结果:10例患者行腹腔镜行双侧肾蒂淋巴管结扎术后,均恢复正常。10例患者平均手术时间为165min;术中平均出血量为120ml;术后肠道功能恢复时间平均52h;患者术后平均住院时间为7d。术后有7例患者出现肉眼血尿的症状,2例出现皮下气肿的症状,均在术后3d内自行消失。在跟踪随访中发现,无复发现象。结论:腹腔镜行双侧肾蒂淋巴管结扎术治疗双侧乳糜尿具有创口小、出血少、复发少、恢复快、费用低等特点,值得临床推广。

Objective：To evaluate laparoscopic renal lymphatic vessels ligation surgical treatment of bilateral chyluria method,clinical value and clinical efficacy.Methods：A randomly selected hospital in October 2007 to December 2009 bilateral chyluria diagnosed between the 10 patients,its use of laparoscopic bilateral renal lymphatic vessels ligation,intraoperative use of ultrasound knife,did not place titanium clips,the kidney was not completely free,and the time of surgery,surgery,intraoperative complications,blood loss,postoperative recovery and hospital stay for observation and assessment of specific targets.Results：10 patients underwent laparoscopic bilateral renal lymphatic vessels ligation,were back to normal.10 patients mean operative time was 165 min;The mean blood loss was 120 ml;the average recovery time of bowel function after 52 h;The average postoperative hospital stay was 7 days.7 cases of postoperative symptoms of patients with gross hematuria,2 cases of subcutaneous emphysema symptoms,were within 3 days after surgery going away.In tracking follow-up found no evidence of recurrence.Conclusion：Laparoscopic bilateral renal lymphatic vessels ligation bilateral chyluria with a wound,less bleeding,less recurrence,rapid recovery,low lost and so worthy to be popularized.