后腹腔镜下肾癌根治术后乳糜漏的临床分析

Clinical analysis of chylous leakage after retroperitoneal laparoscopic radical nephrectomy

目的：分析后腹腔镜下肾癌根治术后乳糜漏发病原因，探讨其预防策略及治疗方法。方法：回顾性分析2010年2月-2013年2月我院8例后腹腔镜下肾癌根治术后乳糜漏患者的临床资料。结果：术后出现乳糜漏时间平均为（2．5±1．0）d。平均引流量〈200ml／24h4例，200-500ml／24h3例，500-1000ml／24h1例，所有患者均在接受了红霉素局部灌注、生长抑素类似物皮下注射加持续引流、低脂优质蛋白饮食、预防感染等综合治疗后痊愈。结论：采用药物加控制饮食、持续引流的综合方案治疗后腹腔镜下肾癌根治术后乳糜漏安全有效。

Objective： To investigate the etiology, diagnosis and prevention of chylous leakage after retroper- itoneal laparoscopic radical nephrectomy. Method： Eight cases of chylous leakage after retroperitoneal laparoscopic radical nephretomy were retrospectively reviewed from February 2010 to February 2013. Result： The mean time of occurrence of postoperative chylous leakage was （2.5±1.0） d. The mean drainage volume was 〈200 ml/24 h in four cases, 200-500 ml/24 h in three cases and 500-1 000 ml/24 h in one patient. All patients were cured with combined therapy including local perfusion of erythrocin, subcutaneous injection and continuing drainage of soma- tostatin analogue, low fat with quality protein diet, anti-infection treatment. Conclusion： The comprehensive ther- apy of diet control, continuing drainage and medication can be safe and effective for the treatment of chylous leak- age after retroperitoneal laparoscopic radical nephrectomy.