后腹腔镜与开放手术行肾蒂淋巴管结扎术治疗乳糜尿的临床效果比较

目的:通过与开放性肾蒂淋巴管结扎术的临床效果比较,评价后腹腔镜肾蒂淋巴管结扎术的临床价值。方法:回顾性分析后腹腔镜肾蒂淋巴管结扎术54例(A组)及开放性肾蒂淋巴管结扎术29例(B组)的临床资料,就两组患者一般资料、手术时间、术中出血量、术后肠道功能恢复时间、术后止痛药用量、术后住院天数、术后感染和复发率等指标进行比较。根据数据类型选用χ~2检验、两样本t检验或Wilcoxon秩和检验,P0.05为差异有统计学意义。结果:两组患者的一般资料相似,差异无统计学意义,具有可比性。后腹腔镜手术组在手术时间、术中出血量、术后肠道功能恢复时间、术后止痛药用量、术后住院天数、术后感染和术后乳糜尿复发率等方面优于开放手术组,差异有统计学意义(P0.05)。结论:后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿疗效肯定,与传统的开放性手术相比,创伤小、恢复快、疗效满意,是目前治疗乳糜尿较理想的手术方法,值得进一步推广。

A Comparison of the Clinical Effects Between Retroperitoneal Laparoscopic and Open Surgical Renal Pedicle Lymphatic Disconnection for the Treatment of Chyluria

Objective：To assess the clinical value of retroperitoneal laparoscopic renal pedicle lymphatic discon nection by comparing its clinical effects with those of open surgery. Methods：Clinical data about 54 cases （group A） and 29 cases （ group B） with chyluria respectively treated by retroperitoneal laparoscopic and open surgical re nal pedicle lymphatic disconnection were analyzed retrospectively＇. The demographics of patients, operation time, intraoperative blood loss , time of intestinal function postoperative recovery, analgesic dosage, postoperative hos pital stay, incidence of postoperative infections and recurrence rate of the 2 groups were compared by student-test, chi square test and Wileoxon rank sum test for statistical analysis according to data types. Statistical significance was defined as P〈 0.05. Results： There are no significant differences in the demographics of patients between two groups, so they are comparable. In group A, operation time, intraoperative blood loss, time of intestinal function postoperative recovery , analgesic dosage, postoperative hospital stay, incidence of postoperative infections and re- currence rate are superior to those in group B, statistical differences are significant （P〈0.05）. Conclusions：There is a definite therapeutic effect in retroperitoneat laparoscopic renal pedicle lymphatic disconnection for treatment of chyluria, and it has more advantages in less injury, rapid postoperative recovery, excellent effects than open sur gery, and as a result, becomes a better alternative surgical method deservable to be further popularized for treat ment of chyluria.