经后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿16例疗效分析

Analysis on the Treatment Result of 16 Cases of Trans-retroperitoneoscopic Ligation of Renal Lymphatic Vessels on Chylous Urine

目的 探讨经后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿的临床疗效.方法 选取2010年1月-2013年1月在我院就诊的乳糜尿患者16例为研究对象,所有患者均行经后腹腔镜肾蒂淋巴管结扎术.手术步骤主要包括肾周淋巴管剥离、肾门淋巴管剥离及榆尿管周围淋巴管剥离.结果 16例手术均获成功,无中转开放手术.平均手术时间（90.35±6.17） min,术中平均出血（48.26±4.83） ml.所有患者术后当天乳白色尿液消失,术后4d乳糜尿试验均为阴性.4例患者术后轻度血尿,出院前消失.患者均获得6～12个月的随访,未发现乳糜尿复发.结论 腹腔镜肾蒂淋巴管结扎术治疗乳糜尿具有复发率低、患者痛苦小、创伤小、出血少和恢复快等优点,是目前治疗乳糜尿比较理想的手术方法.

OBJECTIVE To investigate the clinical efficacy of trans-retroperitoneoscopic ligation of renal lymphatic vessels on chylous urine. METHODS A total of 16 patients with chylous urine admitted from Jan. 2010 to Jan. 2013 in our hospital served as study objects and were treatment with trans-retroperitoneoscopic ligation of renal lymphatic vessels. The surgical procedures included lymphatic vessel decollement around kidney, in renal hulum and around ureter.RESULTS All patients were successfully completed the surgeries without transit open surgery. The mean surgical time and peri-operative hemorrhage were （90.35±6.17） min and （48.26±4.83） ml respectively. Chylous urine disappeared the day after surgery and ehylous urine test showed as negative 4 d after treatment. 4 patients had slight hematuresis, which disappeared before discharge. After 6 - 12 of follow up, no patient was observed with recurrent ehylous urine. CONCLUSION Trans-retroperitoneoscopie ligation of renal lymphatic vessels had low rate of recurrence, slight pain and trau- ma, tess hemorrhage and rapid recovery, which became an ideal surgery in treating chylous urine.