摘要
目的评价开放式与经后腹腔镜肾蒂淋巴管结扎术的临床价值。方法2001年1月至2003年12月采用肾蒂淋巴管结扎术治疗乳糜尿患者19例。后腹腔镜组10例,男6例,女4例,平均年龄45岁;开放手术组9例,男5例,女4例,平均年龄42岁。对2种术式手术时间、术后住院天数、术中平均出血量、术后并发症发生率等项目进行统计分析。结果后腹腔镜与开放手术组手术时间分别为(68.4±39.2)min和(125.6±39.2)min,术后住院天数分别为(5.3±1.1)d和(9.8±2.3)d,术中出血量分别为(47.6±38.2)ml和(294.9±289.1)ml。组间比较差异均有统计学意义(P<0.001)。后腹腔镜组术后无并发症;开放手术组术后因感染或脂肪液化伤口愈合不良3例,并发重度肺部感染及重度代谢性酸中毒1例,术后出现低血压(<90/60mmHg)2例。2组患者术后随访6～12个月,乳糜尿无复发。结论后腹腔镜肾蒂淋巴管结扎术在手术时间、术中出血量和术后恢复等方面明显优于开放手术。
Objective To evaluate and compare retroperitoneoscopic renal pedicle lymphatic disconnection with open surgery for chyluria. Methods A total of 19 eases of ehyluria underwent renal pedicle lymphatic disconnection. Of them 10 cases （6 men and 4 women;mean age,45 years） underwent retro- peritoneoscopic surgery and 9 cases （5 men and 4 women;mean age ,42 years） underwent open surgery. The operative time,post-operative hospital stay, average intra-operative bleeding volume and incidence of postoperative complications of the 2 groups were analyzed and compared. Results The 2 surgical procedures were both successful. The operative time was （68.4 ±39.2）min and （125.6 ±39.2 ）min, respectively, with retroperitoneoscopic and open surgery. The postoperative hospital stay was （5.3 ± 1.1 ） d and （9.8 ± 2.3 ） d, respectively; and the average intra-operative bleeding volume was （47.6 ± 38.2 ） ml and （ 294.9 ± 289.1 ） ml,respectively. The differences between the 2 groups were significant （P 〈 0. 001 ）. No complication occurred in retroperitoneoseopie renal pedicle lymphatic disconnection group; while in open surgery group, postoperatively, hypotension （ 〈 90/60 mm Hg, 1 mm Hg = 0.133 kPa） occurred in 2 cases ; severe pulmonary infection with metabolic acidosis, in 1 case and poor wound healing in 3 cases because of infection or fat liquefaction. Follow-up of 6 - 12 months showed no recurrence of ehyluria in both groups. Conclusions The operative time,intraoperative bleeding volume and postoperative recovery with retroperitoneoscopic renal pedicle lymphatic disconnection were superior to those with open surgery. In spite of the greater technical difficulty with retroperitoneoscopie approach,it has more advantages than open approach.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2006年第2期111-113,共3页
Chinese Journal of Urology
