3D腹腔镜和2D腹腔镜下肾蒂淋巴管结扎术治疗乳糜尿对比分析

Renal pedicle lymphatic disconnection under retroperitoneoscopic in treatment of intractable chyluria: 3D imaging laparoscopy vs 2D imaging laparoscopy

目的比较3D腹腔镜和传统2D腹腔镜下肾蒂淋巴管结扎术治疗乳糜尿的手术效果,探讨3D腹腔镜下肾蒂淋巴管结扎术的安全性、可靠性及优越性。方法单侧乳糜尿患者49例,分为3D腹腔镜组(26例)和2D腹腔镜组(23例),均经腹膜后入路由经验丰富的同一术者完成手术,比较两组患者手术时间、术中出血量、术后住院时间、术后复发情况。结果 3D腹腔镜组的手术时间、术中出血量分别为(95.2±30.3)分钟、(30.0±12.7)ml;2D腹腔镜组分别为(120.4±25.8)分钟、(55.0±21.7)ml;3D腹腔镜组手术时间及出血量与2D腹腔镜组比较,差异有统计学意义(P<0.05)。两组术后平均住院时间比较,差异无统计学意义,49例患者随访至今均未复发。结论 3D腹腔镜下肾蒂淋巴管结扎术治疗乳糜尿安全可行。与2D腹腔镜比较,3D腹腔镜可提供更清晰的视野,有利于术者完成更精细的操作,缩短手术时间,减少术中出血。

Objective To assess the clinical walue of 3D retroperitoneal laparoscopic renal pedicle disconnection by comparing its clinical effects with those of traditional 2D laparoscopic.Methods Clinical data about 49 cases from our department with chyluria respectively treated by 3D retroperitoneal laparoscopic and 2D laparoscopic renal pedicle disconnection were analyzed retrospectively.They were divided into 3D group（26 cases）and 2D group（23 cases）,and operated by the same salty doctor.The operation time,intraoperative blood loss,postoperation hospital stay and recurrence rate of the two group were compared.Results The operation time in 3D group[（95.2±30.3）min] was shorter than 2D group[（120.4±25.8）min,P〈0.05].The intraoperative blood loss in 3D group[（30.0±12.7）ml] was less than 2D group[（55.0±21.7）ml,P〈0.05].There were no difference in postoperation hospital stay between the two groups.All of the cases were not recurred.Conclusion 3D Retroperitoneoscopic renal pedicle lymphatic disconnection for treatment of chyluria is safty and feasible.3D laparoscopy provides high-quality 3D endoscopic view and facilitates precise manipulation during surgery,resulting in shorter operation time and intraoperative blood loss compared with 2D laparoscopy.