目的 评价后腹腔镜肾蒂淋巴管结扎术的临床价值. 方法 回顾性分析2003年1月～2009年12月肾蒂淋巴管结扎术治疗乳糜尿46例的临床资料,其中后腹腔镜组19例,开放组27例,比较2组的手术时间、术中出血量、术后疼痛、术后拔管时间、术后住院时间、随访时间、复发率及并发症. 结果 与开放组相比,后腹腔镜组手术时间短[(94.3±18.4)min v8.(134.9±25.0) min,t=-6.013,P=0.000],术中出血量少[(55.0+29.8)ml vs.(148.7+54.9)ml,t=-6.755,P=0.000],术后使用镇痛药物者少[36.8％ (7/19)vs.85.2％ (23/27),x2=11.490,P=0.001],术后住院时间短[(5.1±0.9)dv8.(11.7±2.2)d,t=- 14.279,P=0.000].2组引流管留置时间、并发症发生率、复发率、随访时间差异均无显著性(P＞0.05). 结论 后腹腔镜肾蒂淋巴管结扎术治疗乳糜尿微创、安全、有效.%Objective To evaluate the clinical value of retroperitoneoscopic renal pedicle lymphatic disconnection for the treatment of chyluria. Methods From January 2003 to December 2009, we retrospectively analyzed the data of 46 patients with chyluria, who received renal pedicle lymphatic disconnection by retroperitoneal laparoscopy (19 cases) , or open surgery (27 cases). The operation time, blood loss, postoperative pain, drainage duration, hospital stay, follow-up time, recurrence rate and complications were compared between the two groups. Results Retroperitoneal laparoscopic group had shorter operation time [ (94.3 ± 18.4)min vs. (134.9±25.0) mm, t= -6.013, P=0.000]; less intraoperative blood loss [(55.0±29.8) ml vs. (148.7±54.9) ml, t = -6. 755, P= 0.000]; lower rate of postoperative analgesia [36.8% (7/19) vs. 85.2% (23/27) ,χ2 = 11. 490, P =0.001 ]; and shorter hospital stay [ (5. 1 ± 0. 9) d vs. (11.7 ±2. 16) d, t = - 14. 279, P = 0. 000] , compared to open surgery group. No significant difference was found in drainage duration, rates of postoperative complication and recurrence, and follow-up time between the two groups (P > 0. 05). Conclusions Retroperitoneoscopic renal pedicle lymphatic disconnection is a safe, minimally invasive, and efficient surgical procedure.
展开▼
