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目的比较3D腹腔镜和传统2D腹腔镜下肾蒂淋巴管结扎术治疗乳糜尿的手术效果,探讨3D腹腔镜下肾蒂淋巴管结扎术的安全性、可靠性及优越性。方法单侧乳糜尿患者49例,分为3D腹腔镜组(26例)和2D腹腔镜组(23例),均经腹膜后入路由经验丰富的同一术者完成手术,比较两组患者手术时间、术中出血量、术后住院时间、术后复发情况。结果 3D腹腔镜组的手术时间、术中出血量分别为(95.2±30.3)分钟、(30.0±12.7)ml;2D腹腔镜组分别为(120.4±25.8)分钟、(55.0±21.7)ml;3D腹腔镜组手术时间及出血量与2D腹腔镜组比较,差异有统计学意义(P<0.05)。两组术后平均住院时间比较,差异无统计学意义,49例患者随访至今均未复发。结论 3D腹腔镜下肾蒂淋巴管结扎术治疗乳糜尿安全可行。与2D腹腔镜比较,3D腹腔镜可提供更清晰的视野,有利于术者完成更精细的操作,缩短手术时间,减少术中出血。
Objective To compare the operative effects of 3D laparoscopic and traditional 2D laparoscopic renal pedicle lymphatic ligation in the treatment of chyluria and to explore the safety, reliability and superiority of 3D laparoscopic renal pedicle lymphatic drainage. Methods Forty-nine patients with unilateral chyluria were divided into 3D laparoscopic group (26 cases) and 2D laparoscopic group (23 cases). All patients underwent retroperitoneal approach to complete the operation with the same surgeon. The operation time , Intraoperative blood loss, postoperative hospital stay, postoperative recurrence. Results The operation time and intraoperative blood loss of 3D laparoscopic group were (95.2 ± 30.3) min and (30.0 ± 12.7) ml, respectively, while those of 2D laparoscopic group were (120.4 ± 25.8) min and (55.0 ± 21.7) ml respectively Laparoscopic operation time and bleeding volume compared with the 2D laparoscopic group, the difference was statistically significant (P <0.05). The average postoperative hospital stay was no significant difference between the two groups, 49 patients were followed up so far have not relapsed. Conclusion 3D laparoscopic renal pedicle lymphatic drainage for the treatment of chyluria is safe and feasible. Compared with 2D laparoscopy, 3D laparoscopy can provide a clearer field of vision, which facilitates the operator to perform finer operations, shorten the operation time and reduce intraoperative bleeding.