后腹腔镜与开放肾蒂淋巴管结扎术治疗乳糜尿疗效分析

目的：评价后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿的临床价值。方法：回顾分析后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿18例（A组）及开放组20例（B组）的临床资料。结果：手术操作时间分别为A组（76±31）min、B组（113±26）min；手术中出血量A组（25±29）ml、B组（190±76）ml；术后肠功能恢复时间A组（33±9）h、B组（69±14）h；术后下床活动时间A组（39±8）h、B组（74±12）h；术后住院天数A组（6．7±2．5）天、B组（12．4±4．1）天；住院总天数A组（14．8±4．7）天、B组（23．9±6．4）天；A组并发症方面明显少于B组，差异有统计学意义（P〈0．05或P〈0．01）；手术治疗费用A组（7582±1952）元、B组（3044±1015）元；B组在手术治疗费用方面少于A组，差异有统计学意义（P〈0．05或P〈0．01）。结论：后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿借助腹腔镜的放大作用，可清楚辨认肾门处的淋巴管，使淋巴管结扎更完全，具有仓0伤小、出血量少，术后卧床和住院时间短、无明显的并发症、恢复快、术后无复发等优点。但应严格掌握手术适应证，积极做好围手术期处理。

Ligation of Renal Lymphatic Vessels for Chyluria: Retroperitoneoscopy vs Open Surgery

Objective：To evaluate the clinical value of retroperitoneoscopic ligation of renal lymphatic vessels for the treatment of chyluria. Methods： The comparison analysis of ligation of renal lymphatic vessels to treat chyluria between retroperitoneoscopic 18 cases （A group） and open surgery group ,20 patients （B group） Results：The two surgical procedures were both successful. The operative time was （ 76 ± 31） rain and （ 113 ± 26） min, respectively, of A group and B group, intraoperative blood loss was（25±29）ml and （190±76）m1. postoperative intestinal recovery was （33±9） h and （69± 14） h . The time getting out of bed postoperative was （39 ± 8） h and （74± 12） h. postoperative hospital stay was （6.7±2.5）d and （12.4±4.1）d. total hospital stay was （14.8±4.7）d and （23.9±6.4）d. the complications of group A was less than that of group I3, which showed a significant difference（P〈0.05 or P〈0.01）. the operative cost was （7 582±1 952） yuan and （3 044±1 015） yuan, there was a significant difference between the two groups （P〈0.05 or P〈 0.01）. Conclusions： Due to the magnified image provided by laparoseopy, lymphatic vessels ligation;could be performed more complete. Retroperitoneoscopic ligation of renal lymphatic vessels for the treatment of chyluria has the advantages of mini invasion, less blood loss, short postoperative in bed and hospital stay, no obvious surgical complications, rapid recovery and no recurrence Postoperative. But the surgical indications should be evaluated strictly and perioperative management Should he actively carried out.