探讨经后腹膜腔利用腹腔镜改良肾蒂周淋巴管阻断术治疗乳糜尿的疗效。

2017年3月至2018年7月，茂名市电白区人民医院泌尿外科对7例乳糜尿患者行腹腔镜改良肾蒂周淋巴管阻断术治疗，观察7例患者的手术时间、术中出血量、引流管与尿管的拔管时间、术后连续3 d的乳糜尿试验结果及术后不良反应的发生情况，术后随访2～17个月。

7例患者手术均于镜下顺利完成，平均手术时间为75 min，术中平均出血量为7.5 ml；于术后1～4 d拔除腹膜腔引流管，6～7 d拔除尿管；所有患者术后即无乳白色尿液，术后连续3 d复查乳糜尿试验均为阴性；随访期间，均无明显肾周下坠痛及患侧肾下垂情况发生。1例复发者经改善饮食及减少运动量1周后乳糜尿症状消失。

经后腹膜腔利用腹腔镜改良肾蒂周淋巴管阻断术治疗乳糜尿保持了肾门部血管、肾盂生理性伸直，手术时程短，术中出血少，患者临床症状消失快，疗效确切。

To evaluate the clinical efficacy of modified retroperitonescopic renal pedicle lymphatic disconnection for treatment of chyluria.

From March 2017 to July 2018, 7 patients with chyluria underwent modified retroperitonescopic renal pedicle lymphatic disconnection in Department of Urological Surgery of People's Hospital of Dianbai District were enrolled in this study. The operation time, intraoperative blood loss, extubation time of drainage tube and catheter, chyluria test results for consecutive 3 days after operation and incidence of postoperative adverse reactions were observed. All patients were followed up for 2-17 months.

The surgeries were successfully completed in 7 patients. The average operation time was 75 min. The average intraoperative blood loss was 7.5 ml. The drainage tube was removed from the peritoneal cavity at postoperative 1-4 d, and the catheter was removed 6-7 days after surgery. All patients had no white urine immediately after operation. The chyluria test was negative for consecutive 3 days after operation. During postoperative follow-up, no obvious perirenal pain or nephroptosis was reported on the affected side. The symptoms of chyluria disappeared in 1 recurrent patient after improving diet and reducing exercise for 1 week.

Modified retroperitonescopic renal pedicle lymphatic disconnection is an efficacious treatment of chyluria, which maintains the physiological straightening of blood vessels and renal pelvis in the renal hilus, shortens operation time, causes mild intraoperative hemorrhage and accelerates the mitigation of clinical symptoms.