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Laparoscopic renal pedicle lymphatic disconnection is the most effective method for treating chyluria that has failed to respond to conservative management. Chylous hemothorax is a rare clinical occurrence resulting from the anatomic abnormality. This paper reported a case, who was admitted with painless gross hematuria for 1 month and was diagnosed with left chylous hematuria. Laparoscopic left renal pedicle lymphatic disconnection was performed, and bilateral chylous hemothorax occurred after the operation. After conservative treatment such as bilateral closed thoracic drainage and blood transfusion support, the patient recovered well. After 2 months of follow-up, there was no obvious effusion in the bilateral thoracic cavity, and the chylous test of urine fluid was negative.
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Objective To explore the clinical safety and efficacy of self-made single-port retroperitoneoscopic renal pedicle lymphatic disconnection for chyluria. Methods From Feb 2013 to Mar 2016, clinical data of 34 patients were collected. Of them, 16 cases underwent self-made single-port retroperitoneoscopic renal pedicle lymphatic disconnection and 18 cases underwent three port retroperitoneoscopic renal pedicle lymphatic disconnection. No significant difference was shown in age, body mass index between the two groups (P > 0.05). Mean operative time, estimated bleeding volume, drainage time, postoperative hospital stay, postoperative pain evaluation, satisfaction scores of incision were compared between the two groups. Results All procedures were successfully performed without conversion to open surgery. Compared with the three port surgery group, results in the single-port group were superior in terms of mean operative time [(102.3 ± 16.1) versus (132.4 ± 21.6) min, P < 0.05], there were no significant differences in estimated blood loss, drainage time, postoperative hospital stay, the date in postoperative pain evaluation, satisfaction scores of incision shown that single-port group was superior to three port group. Conclusion Our initial experience revealed that single-port retroperitoneoscopic renal pedicle lymphatic disconnection was a safe, effective, cost-effective and less-invasive procedure for chyluria with improved postoperative pain and cosmetic results.
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Objective To assess the clinical walue of 3D retroperitoneal laparoscopic renal pedicle disconnection by comparing its clinical effects with those of traditional 2D laparoscopic.Methods Clinical data about 49 cases from our department with chyluria respectively treated by 3D retroperitoneal laparoscopic and 2D laparoscopic renal pedicle disconnection were analyzed retrospectively.They were divided into 3D group(26 cases)and 2D group(23 cases),and operated by the same salty doctor.The operation time,intraoperative blood loss,postoperation hospital stay and recurrence rate of the two group were compared.Results The operation time in 3D group[(95.2±30.3)min] was shorter than 2D group[(120.4±25.8)min,P<0.05].The intraoperative blood loss in 3D group[(30.0±12.7)ml] was less than 2D group[(55.0±21.7)ml,P<0.05].There were no difference in postoperation hospital stay between the two groups.All of the cases were not recurred.Conclusion 3D Retroperitoneoscopic renal pedicle lymphatic disconnection for treatment of chyluria is safty and feasible.3D laparoscopy provides high-quality 3D endoscopic view and facilitates precise manipulation during surgery,resulting in shorter operation time and intraoperative blood loss compared with 2D laparoscopy.
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Objective To evaluate the feasibility and efficacy of laparoscopic single-port transumbilical renal pedicle lymphatic disconnection (TRPLD) for treatment of chyluria. Methods Nine cases of chyluria underwent laparoscopic single-port TRPLD. In all cases a 2-3 cm single inverted Ushaped supraumbilical incision was made, two 5-mm and one 12-mm trocars were inserted, and a medical rubber glove was sutured surrounding the three trocars and incision was made for gas proofing.Conventional straight and flexible instruments were used for dissection. Results All laparoscopic operations were successfully completed without conversion to open surgery. The mean operative time was 135 (96-178) minutes, and the mean estimated blood loss was 126 (50-250) ml. Chyluria disappeared in all patients after operation and did not reoccur during the follow-up (1 - 6 months).Conclusions Laparoscopic single-port transumbilical TRPLD represents a feasible and novel mini-invasive option for patients with chyluria.
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Objective:To summarize the experience of retroperitoneoscopic renal pedicle lymphatic disconnection in the management of chyluria,and to investigate a new minimally invasive treatment of chyluria. Methods:9 cases of chyluria were treated by retroperitoneoscopic renal pedicle lymphatic disconnection from Jan 2005 to Dec 2008 with 7 male ones and 2 female ones. The average age was 48 years. 8 of 9 cases obtained success and 1 of 9 cases was converted to open surgery. Operation time, blooding volume, postoperative complication and hospitalization stay, and the operative effect were observed. Results:The operation time was from 65 to 105 min,with the average of 70 min. The blooding volume was from 50 to 100ml, with the average of 60ml. Chyluria disappeared immediately after operation in all patients. Postoperative stay was from 5 to 7d and no complication happened. Conclusion:Retroperitoneoscopic renal pedicle lymphatic disconnection for chyluria is a effective and efficienl method in the management of chyluria. And it is also safe , minimally invasive , with less blood loss, fewer complications , and short hospital stay .