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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48～65min,平均(55.9±5.9)min。术中出血量20～70ml。术后住院时间5～7d,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。
Objective: To investigate the surgical method and effect of retroperitoneal laparoscopic renal fascia membrane suspension ligation and renal pedicle lymphatic drainage in the treatment of chyluria. Methods: Sixteen patients with chyluria were treated by retroperitoneal adrenal fascia suspension ligation and renal pedicle lymphadenectomy. There were 5 males and 11 females, aged 54-74 years (average 64.7 ± 6.6 years). All patients were observed operation time, intraoperative blood loss, postoperative hospital stay, complications and prognosis, and clinical analysis of relevant indicators. Results: The operation of 16 patients was successfully completed without any transfer of open surgery. The operation time was 48-65 minutes, with an average of (55.9 ± 5.9) min. Intraoperative bleeding 20 ~ 70ml. The postoperative hospital stay was 5 to 7 days, with an average of (6.4 ± 2.0) days. Postoperative chyluria disappeared in all patients. Followed up for 16 to 36 months, no recurrence, no complications such as renal ptosis and hemorrhage around renal pedicle. Conclusion: The retroperitoneal laparoscopic superficial fascia suspension ligation of renal pedicle lymphatic dissection is a safe and feasible surgical treatment of chyluria, which is worthy of clinical promotion.