肾蒂淋巴管结扎术治疗乳糜尿136例疗效观察

Renal pedicle lymphatic disconnection in the treatment of chyluria:analysis of 136 cases

目的 探讨不同术式肾蒂淋巴管结扎术治疗乳糜尿的方法和效果.方法 回顾性分析2005年2月~2011年6月肾蒂淋巴管结扎术136例治疗乳糜尿的临床资料,其中后腹腔镜手术组74例,开放手术组62例,比较2 组的手术时间、术中出血量、术后住院时间、术后恢复时间及复发情况、并发症.术后随访时间6~72个月,平均32个月.结果 136例均完成手术.与开放手术组相比,后腹腔镜手术组手术时间短（ 116±25.1）min vs（143±27.8） min,P〈0.01、术中出血量少（ 82.0±25.5） ml vs（ 216±54.9） ml,P〈0.01,术后住院时间短（11.7±3.2）d vs（9.2±2.5） d,P〈0.05,术后恢复劳动力时间（1.4±1.0）d vs（4.7±2.1）d,P〈0.05.术后134例恢复良好、无复发,后腹腔镜组1例术后1个月复发,开放组1例术后12个月复发,术中术后两组无重大并发症.结论 采用肾蒂淋巴管结扎术治疗乳糜尿是一种有效、安全的手术方式.后腹腔镜下手术较开放手术有较明显优势.

Objective To explore renal pedicle lymphatic disconnection in the treatment of chyluria. Methods Clinical data of 62 cases of open surgical operation and 74 cases of retroperitoneal laparoscopy in renal pedicle lymphatic disconnection were analysed. The operation time, blood loss, follow-up time, recurrence rate and complications were compared between the two groups. Results Retroperitoneal laparoscopic group had shorter operation time （ 116 ± 25.1 ） min vs （ 143 ± 27.8） min, P 〈 0. 01, less intraoperative blood loss （ 82. 0 ±25.5 ） ml vs （ 216 ± 54. 9 ） ml, P 〈 0. 01, shorter hospital stay （ 11.7±3.2 ） d vs （ 9. 2 ± 2. 5 ） d, P 〈 0. 05 and shorter recovery time （ 1.4 ±1.0） d vs （4. 7 ± 2. 1 ） d, P 〈 0. 05. Only 1 case in retroperitoneal laparoscopic greup recurrened after 1 month, 1 case in open surgery group recurrened after 12 months. Nerther of 2 groups had significant complications. Conclusion Renal pedicle lymphatic disconnection in the treatmeat chyluria was a efficient,safe and reliable methods.