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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疗效。方法:对采用后腹腔镜肾蒂淋巴管结扎术治疗的52例乳糜尿患者临床资料进行回顾分析。结果:2例因术中损伤血管转为开放手术,其余均成功完成后腹腔镜手术。手术时间95～150 min,术中出血50～300 ml;12例术后出现肉眼血尿,经利尿、止血治疗后血尿消失,术后未出现严重并发症;术后住院6～12 d,出院时尿液均转清;术后随访0.5～3年,48例患者获随访,其中4例于术后9个月内复发,经膀胱镜诊断为对侧乳糜尿,经手术后痊愈,其余患者无复发;随访患者无肾萎缩、肾下垂等远期并发症。结论:后腹腔镜肾蒂淋巴管结扎是治疗乳糜尿的有效方法,手术创伤小,术后效果满意;改良术中操作方法可缩短手术时间,提高手术安全性。
Objective: To investigate the effect of retroperitoneal laparoscopic renal pedicle lymphatic drainage in the treatment of chyluria. Methods: The clinical data of 52 cases of chyluria treated by retroperitoneal laparoscopic renal pedicle lymphatic drainage were retrospectively analyzed. Results: Two patients underwent open surgery due to intraoperative vascular injury, and the others were successfully performed laparoscopic surgery. The operation time was 95-150 min and intraoperative blood loss was 50-300 ml. Twelve patients had gross hematuria after hemorrhage. After diuresis and hemostasis, hematuria disappeared and no serious complication occurred after operation. The patients were hospitalized for 6-12 days and discharged Urine were cleared; after follow-up 0.5 to 3 years, 48 patients were followed up, of which 4 cases relapsed within 9 months after surgery, the contralateral chyluria by cystoscopy, cured after surgery, and the remaining patients without Recurrence; patients with no renal atrophy, renal ptosis and other long-term complications. Conclusion: Retroperitoneal laparoscopic renal pedicle lymphatic ligation is an effective method for the treatment of chyluria. The surgical trauma is small and the postoperative result is satisfactory. The improved operation method can shorten the operation time and improve the operation safety.