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目的:探讨后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿的临床疗效。方法:2007年10月～2008年10月收治13例乳糜尿患者,其中男5例,女8例,年龄28～54岁(平均38岁),病史1～15年。乳糜尿来自左侧6例,右侧7例。13例均行后腹腔镜肾蒂淋巴管结扎术。结果:13例手术均取得成功,无一例转开放手术,手术时间60～115 min(平均90 min),术中出血量10～80 ml(平均40 m1),均未输血。13例患者术后当天乳糜尿均消失,未出现并发症。术后平均住院5.5天。随访0.5～1年,仅1例出现对侧复发再次行患侧后腹腔镜肾蒂淋巴管结扎术,其他患者均无乳糜尿症状复发。结论:后腹腔镜肾蒂淋巴管结扎术是一种治疗乳糜尿安全、有效的方法,具有创伤小、并发症少、术后恢复快、复发率低等优点,值得临床推广应用。
Objective: To investigate the clinical effect of retroperitoneal laparoscopic renal pedicle lymphatic drainage in the treatment of chyluria. Methods: From October 2007 to October 2008, 13 patients with chyluria were admitted, including 5 males and 8 females, aged 28-54 years (average 38 years) with a history of 1-15 years. Chyluria from the left in 6 cases, right in 7 cases. Thirteen patients underwent laparoscopic renal pedicle lymphatic ligation. Results: All the 13 surgeries were successful. None of them underwent open surgery. The operation time ranged from 60 to 115 minutes (mean 90 minutes) and the blood loss was 10 to 80 ml (average 40 ml). No blood transfusion was performed. Thirteen patients on the day after surgery, chyluria disappeared, no complications. The average postoperative hospital stay 5.5 days. Follow-up 0.5 to 1 year, only 1 case of contralateral recurrence again after the ipsilateral laparoscopic nephroureterectomy, other patients no recurrence of chyluria symptoms. Conclusion: Retroperitoneal laparoscopic renal pedicle lymphatic drainage is a safe and effective method for the treatment of chyluria. It has the advantages of less trauma, less complications, quick recovery after operation and low recurrence rate. It is worthy of clinical application.