腹腔镜下肾蒂淋巴管结扎术后双侧乳糜血胸1例报告

Acase report of bilateral chylous hemothorax presenting after laparoscopic renal pedicle lymphaticdisconnection

对于保守治疗无效的乳糜尿患者,肾蒂淋巴管结扎术是最有效的方法。由于解剖异常而导致患者术后并发乳糜血胸临床罕见。本文报道1例,因无痛性肉眼血尿1个月入院,诊断为左侧乳糜血尿,行腹腔镜下左侧肾蒂淋巴管结扎术,术后并发双侧乳糜血胸。经双侧胸腔闭式引流、输血等保守治疗后康复出院。术后随访2个月,双侧胸腔无明显积液,尿液乳糜定性阴性。

Laparoscopic renal pedicle lymphatic disconnection is the most effective method for treating chyluria that has failed to respond to conservative management.Chylous hemothorax is a rare clinical occurrence resulting from the anatomic abnormality.This paper reported a case,who was admitted with painless gross hematuria for 1 month and was diagnosed with left chylous hematuria.Laparoscopic left renal pedicle lymphatic disconnection was performed,and bilateral chylous hemothorax occurred after the operation.After conservative treatment such as bilateral closed thoracic drainage and blood transfusion support,the patient recovered well.After 2 months of follow-up,there was no obvious effusion in the bilateral thoracic cavity,and the chylous test of urine fluid was negative.