CAJ | 학술논문

目的与脂肪囊内完全或次全性游离途径肾蒂淋巴管结扎术进行对比，评价后腹腔镜下肾脂肪囊外途径肾蒂淋巴管结扎术的临床疗效。方法回顾性分析经后腹腔镜下脂肪囊外途径肾蒂淋巴管结扎术（Ⅰ组）及脂肪囊内途径肾脏完全或次全游离行肾蒂淋巴管结扎术（Ⅱ组）的111例乳糜尿患者临床资料，比较两组手术时间、术中出血量、术后镇痛率、术后胃肠功能恢复时间、放置引流管时间、术后恢复工作时间、术后住院时间及术后并发症等指标间的差异。结果Ⅰ组在手术时间、术中出血量、术后镇痛率、术后胃肠功能恢复时间、放置引流管时间、术后恢复工作时间、术后住院时间及术后血尿、肾下垂等并发症方面均优于Ⅱ组，差异有统计学意义（P＜0．05）。结论后腹腔镜下肾脂肪囊外肾蒂淋巴管结扎术治疗乳糜尿效果肯定，与脂肪囊内手术途径比较，该方法创伤小、恢复快、复发率低，可完全替代肾脂肪囊完全或次全性游离肾蒂淋巴管结扎手术，值得临床推广。
목적여지방낭내완전혹차전성유리도경신체림파관결찰술진행대비，평개후복강경하신지방낭외도경신체림파관결찰술적림상료효。방법회고성분석경후복강경하지방낭외도경신체림파관결찰술（Ⅰ조）급지방낭내도경신장완전혹차전유리행신체림파관결찰술（Ⅱ조）적111례유미뇨환자림상자료，비교량조수술시간、술중출혈량、술후진통솔、술후위장공능회복시간、방치인류관시간、술후회복공작시간、술후주원시간급술후병발증등지표간적차이。결과Ⅰ조재수술시간、술중출혈량、술후진통솔、술후위장공능회복시간、방치인류관시간、술후회복공작시간、술후주원시간급술후혈뇨、신하수등병발증방면균우우Ⅱ조，차이유통계학의의（P＜0．05）。결론후복강경하신지방낭외신체림파관결찰술치료유미뇨효과긍정，여지방낭내수술도경비교，해방법창상소、회복쾌、복발솔저，가완전체대신지방낭완전혹차전성유리신체림파관결찰수술，치득림상추엄。
Objective To evaluate the surgical techniques and clinical efficacy of retroperitoneoscopic ligation of renal lymphatic vessels outside adipose capsule and inside adipose capsule for comparison in the treatment of chyluria.Methods Retrospective anal-ysis of the retroperitoneal laparoscopic adipose capsule of kidney pedicle lymphatic duct ligation(group Ⅰ)and adipose capsule pathways in the kidney totally or subtotally free renal pedicle lymphatic ligation(group Ⅱ)and 1 1 1 patients with chyluria clinical data,compared two groups of operation time,bleeding volume,the rate of analgesia,postoperative gastrointestinal function recovery time,drainage time,postoperative recovery time,postoperative hospital stay and postoperative complications and other index differ-ence.Results Retroperitoneal laparoscopic operation group of adipose capsule in operation time,bleeding volume,postoperative an-algesia,postoperative gastrointestinal function recovery time,drainage time,postoperative recovery time,postoperative hospital stay and postoperative complications were better than the adipose capsule of kidney totally or subtotally free operation group,the differ-ence was statistically significant(P<0.05).Conclusion Retroperitoneal laparoscopic renal adipose capsule of kidney pedicle lym-phatic disconnection for the treatment of chyluria effect,and adipose capsule operation ways,the method less trauma,quicker recov-ery,can completely replace the renal adipose capsule total or Sub-total of free kidney pedicle lymphatic disconnection operation,wor-thy of clinical application.