后腹腔镜肾上极筋膜悬吊结扎法肾蒂淋巴管剥脱术治疗乳糜尿(附16例报告)  

Retroperitoneoscopic renal pedicle lymphatic disconnection via suspension and ligation of the fascia of upper pole of kidney in the treatment of chyluria(Report of 16 cases)

作　　者：闫泽晨[1] 贾占奎[1] 顾朝辉[1] 刘会锋[1] 唐晓龙[1] 刘耀雷[1] 姚文诚[1] 曾甫清[2] 杨锦建[1] 

机构地区：[1]郑州大学第一附属医院泌尿外科,河南省泌尿外科研究所,郑州市泌尿外科肿瘤分子生物学重点实验室,郑州450052 [2]华中科技大学同济医学院附属协和医院泌尿外科

出　　处：《临床泌尿外科杂志》2013年第3期193-195,共3页Journal of Clinical Urology

基　　金：国家自然科学基金资助项目(编号81100464/H0424);河南省卫生厅科技攻关项目(编号2011020039)

摘　　要：目的:探讨后腹腔镜肾上极筋膜悬吊结扎法肾蒂淋巴管剥脱术治疗乳糜尿的手术方法和疗效。方法:采用后腹腔镜肾上极筋膜悬吊结扎法肾蒂淋巴管剥脱术治疗乳糜尿患者16例,男5例,女11例,年龄54～74岁,平均(64.7±6.6)岁。所有患者均观察手术时间、术中出血量、术后住院时间、并发症及其预后,并对临床相关指标进行分析。结果:16例患者手术均顺利完成,无中转开放手术者。手术时间48～65min,平均(55.9±5.9)min。术中出血量20～70ml。术后住院时间5～7d,平均(6.4±2.0)d。所有患者术后乳糜尿消失。随访16～36个月,无一例复发,未出现肾下垂、肾蒂周围出血等并发症。结论:经后腹腔镜肾上极筋膜悬吊结扎法肾蒂淋巴管剥脱术是一种治疗乳糜尿安全、可行的手术方法,值得临床推广。Objective： To evaluate the technique and result of retroperitoneoseopic renal pedicle lymphatic dis connection via suspension and ligation of the fascia of upper pole of kidney for the treatment of patients with chyluria. Methods：16 patients with ehyluria were selected, including 5 males and 11 females, 54 to 74 years old （mean 64.7±6.6 y）. All cases underwent retroperitoneoscopic renal pedicle lymphatic disconnection via suspension and ligation of the fascia of upper pole of kidney. The operative time, blood loss, hospital stay after operation,complication and prognosis were analyzedl Results：All operations were successfully completed without conversion to open surgery. The mean operative time was 48-65 rain（mean 55.94±5.9 rain）. The mean blood loss was estimated to be 20-70 ml. Hospital stay after operation was 5-7 d （mean 6.4±2.0 d）. Chyluria disappeared in all patients after surgery, and did not recur during the follow-up period （16-36 mos）. Patients did not occur complications such as nephroptosis and hemorrhage around renal pedicle. Conclusions： Retroperitoneoscopic renal pedicle lymphatic disconnection via suspension and ligation of the fascia of upper pole of kidney is safe and feasible and is worth promoting in further clinical application.

关 键 词：乳糜尿 腹腔镜术 肾蒂淋巴管剥脱术 疗效 肾上极筋膜悬吊 

分 类 号：R572[医药卫生—消化系统] R597[医药卫生—内科学]