后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿(附29例报告)

目的：探讨后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿的手术方法和疗效。方法：对29例乳糜尿均行经后腹腔镜肾蒂淋巴管结扎术(双侧者只做了一侧)。结果：29例患者手术均成功，平均手术时间110min，术中出血量平均84ml，未见明显的外科并发症，术后平均住院7．9d。患者出院时尿液均清亮，26例单侧乳糜尿患者尿乙醚试验全部阴性。随访1～3年，除1例双侧乳糜尿患者在术后3个月因对侧原因出现乳糜尿外，其余患者均无复发。结论：后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿近期疗效较好．具有术中出血量少、微创、淋巴管结扎彻底、术后住院时间短、恢复快等优点，是目前治疗乳糜尿较理想的手术方式。

Experiences in retroperitoneoscopic ligation of renal lymphatic vessels for the treatment of chyluria

Objective:To improve diagnosis and treatment of chyluria, to evaluate the surgical technique and clinical efficacy of retroperitoneoscopic ligation of renal lymphatic vessels for the treatment of chyluria.Methods:Twenty-nine cases of chyluria ,male 8 and female 21,with age ranging from 34 to 64 years (mean,52.1 years),were selected for retroperitoneoscopic ligation of renal lymphatic vessels. Diagnosis was based on cystoscopy and urine examination for the presence of chyle and fat globules. Chyluria was found on the left renal in 17 cases, on the right side in 9 cases and on both sides in 3 cases. The operation time, blood loss, complications during operation or postoperation and the operative efficacy were evaluated.Results:All cases have been successfully treated with retroperitoneoscopic management. The average operation time was 110minutes,the average blood loss was 84 ml and the average hospital stay after operation was 7.9 days. No obvious surgical complications occurred. The urine from all patients was clear when the patients discharged from the hospital. Chyluria disappeared in the 26 unilateral cases. No recurrence of chyluria was found during the follow-up of 1-3 years, except for 1 patient with bilateral chyluria , who was performed unilateral operation primarily .Conclusions:Retroperitoneoscopic ligation of renal lymphatic vessels for the treatment of chyluria is an effective and efficient surgical procedure and has the advantages of less blood loss, minimal invasion, complete lymphatic vessels ligation , short hospital stay and rapid recovery. So far, it is an ideal surgical procedure for treatment of chyluria.