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)
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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48~65 min,平均(55.9±5.9)min。术中出血量20~70 ml。术后住院时间5~7 d,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。Abstract: Objective: To evaluate the technique and result of retroperitoneoscopic renal pedicle lymphatic disconnection via suspension and ligation of the fascia of upper pole of kidney for the treatment of patients with chyluria.Methods: 16 patients with chyluria 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 analyzed.Results: All operations were successfully completed without conversion to open surgery. The mean operative time was 48-65 min(mean 55.9±5.9 min). 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.
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