后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿52例疗效分析

    Curative effect analysis of retroperitoneoscopy renal pedicle lymphatic dissection in the treatment of chyluria in 52 cases

    • 摘要: 目的:探讨后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿的疗效。方法:对采用后腹腔镜肾蒂淋巴管结扎术治疗的52例乳糜尿患者临床资料进行回顾分析。结果:2例因术中损伤血管转为开放手术,其余均成功完成后腹腔镜手术。手术时间95~150min,术中出血50~300ml;12例术后出现肉眼血尿,经利尿、止血治疗后血尿消失,术后未出现严重并发症;术后住院6~12d,出院时尿液均转清;术后随访0.5~3年,48例患者获随访,其中4例于术后9个月内复发,经膀胱镜诊断为对侧乳糜尿,经手术后痊愈,其余患者无复发;随访患者无肾萎缩、肾下垂等远期并发症。结论:后腹腔镜肾蒂淋巴管结扎是治疗乳糜尿的有效方法,手术创伤小,术后效果满意;改良术中操作方法可缩短手术时间,提高手术安全性。

       

      Abstract: Objective:To investigate the curative effects of retroperitoneoscopy renal pedicle lymphatic dissection in the treatment of chyluria.Methods:The clinical data of 52 patients with chyluria treated with retroperitoneoscopy renal pedicle lymphatic dissection were retrospectively analysed.Results:Because of intraoperative vascular injury,2 cases were treated with open surgery.The remaining case's operations were successful.Their operation time and intraoperative blood loss were 95 to 150 minutes and 50 to 300 ml,respectively.There were gross hematuria in 12 patients after operation,which disappeared after treatment,no serious complication was found.The postoperative hospitalization time of all cases were 6 to 12 days,their urine was clear after discharge.The following-up time of 48 cases were from 6 months to 3 years.Four cases recurred during 6 months after operation,they were diagnosed as contralateral chyluria by cystoscopy,and cured after surgery.The remaining following-up patients didn' t recurred and renal atrophy or nephroptosis.Conclusions:retroperitoneoscopy renal pedicle lymphatic dissection in the treatment of chyluria is effective and minimal invasion.Improving surgical method can shorten the operation time and improve surgical safety.

       

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