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目的比较后腹腔镜肾蒂淋巴管剥离结扎术(RPSS)与开放直视下手术(OS)治疗乳糜尿的临床效果。方法手术治疗乳糜尿患者60例,26例(Ⅰ组)行RPSS,34例(Ⅱ组)选用OS,比较两组临床资料。结果两组手术均获成功。与Ⅱ组比较,Ⅰ组手术时间短[(136.58±4.67)minvs.(89.67±3.21)min]、术中出血量少[(35.76±2.34)mlvs.(12.35±3.99)ml]、术后胃肠动力恢复早[(48.89±7.85)hvs.(31.32±9.61)h]、引流管留置时间短[(3.11±1.78)dvs.(1.71±2.11)d]、术后住院时间短[(9.71±4.32)dvs.(6.97±5.33)d](P<0.01)。术后随访72个月,Ⅰ组有2例复发;Ⅱ组有1例复发。结论 RPSS较传统OS具有淋巴管结扎彻底、手术时间短、术中出血少、创伤小、并发症少和术后恢复快等优点。
Objective To compare the clinical effects of laparoscopic renal pedicle lymphatic drainage ligation (RPSS) and open open surgery (OS) for chyluria. Methods Surgical treatment of 60 cases of chyluria patients, 26 cases (Ⅰ group) underwent RPSS, 34 cases (Ⅱ group) selected OS, the clinical data of two groups were compared. Results Both procedures were successful. Compared with group Ⅱ, the operation time of group Ⅰ was shorter than that of group Ⅱ ([(136.58 ± 4.67) min vs (89.67 ± 3.21) min] and the amount of bleeding was less [(35.76 ± 2.34) ml vs (12.35 ± 3.99) ml] The intestinal motility recovery was earlier (48.89 ± 7.85 hvs. (31.32 ± 9.61) h], the drainage catheter was shorter (3.11 ± 1.78 dvs.1.71 ± 2.11 d) and the postoperative length of stay was shorter (9.71 ± 4.32) dvs. (6.97 ± 5.33) d] (P <0.01). After 72 months of follow-up, there were 2 cases of recurrence in group Ⅰ and 1 case of recurrence in group Ⅱ. Conclusion Compared with traditional OS, RPSS has the advantages of complete lymphatic ligation, short operation time, less intraoperative bleeding, less trauma, less complications and quick recovery after operation.