后腹腔镜下改良肾蒂淋巴管结扎术治疗乳糜尿的安全性和疗效分析  

he Study of Safety and Efficacy of Modified Retroperitoneoscopic Renal Pedicle Lymphatic Disconnection for the Treatment of Chyluria

作　　者：吕文伟[1] 霍庆祥[1] 张寒[1] 马魏魏[1] 

机构地区：[1]郑州大学附属洛阳中心医院泌尿外科,471000

出　　处：《中国继续医学教育》2015年第30期72-74,共3页China Continuing Medical Education

摘　　要：目的：分析后腹腔镜下改良肾蒂淋巴管结扎术治疗乳糜尿的安全性和疗效。方法回顾性分析2011年10月～2014年10月单一术者所行的后腹腔镜下改良肾蒂淋巴管结扎术治疗乳糜尿53例，分析手术成功率、手术时间、术中出血量、术后引流量、术后拔管时间、术后卧床时间、术后住院天数、并发症发生率等指标。结果53例手术均成功，1（1.88%）例中转开放手术。手术时间中位值为65（51～141） min；出血量中位值32（18～83）ml；术后引流量中位值16（5～127） ml；术后拔管时间中位值2.7（2.0～5.3）d；术后卧床时间中位值1.7（1.2～2.5）d；术后住院天数中位值6.5（5.0～10.3）d；并发症发生率3.77%（2/53），肾静脉损伤、膈肌损伤各1例。术中、术后均无输血。术后随访3～39个月，平均22个月，乳糜尿消失、无复发，无肾萎缩、肾下垂发生。患者体重增加，营养状况明显改善。结论经后腹腔镜下改良肾蒂淋巴管结扎术治疗乳糜手术时间短，出血少，住院时间短，并发症少，是一种理想的微创治疗方法。Objective To assess the safety and efficacy of modified retroperitoneoscopic renal pedicle lymphatic disconnection for the treatment of chyluria.Methods 53 cases of chyluria undergoing modiifed retroperitoneoscopic renal pedicle lymphatic disconnection from October 2011 to October 2014 by one surgeon were reviewed retrospectively. Data on the success rate of surgery, the operation time, the blood loss during operation, the drainage time after operation, the bed time after operation, the mean hospitalization time after operation and the complications were analyzed.Results 53 patients were all successfully operated, 1 （1.88%） case was transferred to open surgery. The medium operation time was 65 （51~141） min ,the medium blood loss during operation was32 （18~83） ml, the medium drainage time after operation was 16 （5~127） ml, the medium bed time after operation was 1.7 （1.2~2.5） d, the medium mean hospitalization time after operation was 6.5 （5.0~10.3） d, the complication was 3.77% （2/53）, 1 patient had renal vein injury and 1 suffered from diaphragm injury. No blood transfusion occurred. During a follow-up period of 3-39 months （mean 22 months）, chyluria disappeared in all patients without recurrence and renal atrophy or nephroptosis wasn’t occurred. all patients gained weight and nutritional condition was improved. Conclusion The advantages of modiifed retroperitoneoscopic renal pedicle lymphatic disconnection for the treatment of chyluria include shorter operation time, the shorter hospitalization time after operation, and less blood loss and less complications. It’s an ideal and minimally invasive surgical procedure for chyluria.

关 键 词：乳糜尿 后腹腔镜 改良 肾蒂淋巴管结扎术 

分 类 号：R69[医药卫生—泌尿科学]