Tao Zhang1, Jinyou Wang1, Dexin Yu2, Jiaxing Ma1, Haoqiang Shi3, Liangkuan Bi1, Dongdong Xie1, Yi Wang1, Jie Min1. 1. Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China. 2. Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China. wizard_zt1982@163.com. 3. Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Abstract
PURPOSE: To compare the efficacy and safety of two approaches in retroperitoneoscopic renal pedicle lymphatic disconnection (RRPLD) for intractable chyluria: completely or partly mobilize the kidney. MATERIALS AND METHODS: Retrospectively reviewed the clinical data of 77 patients, who underwent RRPLD because of intractable chyluria in our institution. We mobilized the whole affected kidney in 22 patients during the operation, but only dissected the lower part in other 55 patients. Operative time, blood loss, visual analog scale (VAS) score, postoperative bed rest, postoperative hospital stay, recurrence, intraoperative and postoperative complications were compared between the two groups. RESULTS: All operation was successful, and none convert to open. The chyluria was resolved immediately after surgery. Compared with completely mobilized RRPLD (CMR), partly mobilized RRPLD (PMR) was superior in terms of operative time (132.91 ± 35.65 vs. 91.73 ± 24.14 min), blood loss (35.68 ± 8.21 vs. 25.09 ± 7.41 ml), VAS score (4.63 ± 0.44 vs. 2.34 ± 0.80), postoperative bed rest (3.36 ± 0.49 vs. 1.80 ± 0.85 days) and hospital stay (6.77 ± 1.57 vs. 4.98 ± 1.89 days). Compilations occurred in three patients in CMR group and two in PMR. Recurrence was confirmed by cystoscopy in three patients during 3-103-month follow-up, CMR group with 1 and PMR with 2. CONCLUSION: In our study, we found PMR was equally effective and safe as CMR. Moreover, it is more minimally invasive, painless and economical. Therefore, we believe it is unnecessary to completely mobilize the kidney in RRPLD for intractable chyluria.
PURPOSE: To compare the efficacy and safety of two approaches in retroperitoneoscopic renal pedicle lymphatic disconnection (RRPLD) for intractable chyluria: completely or partly mobilize the kidney. MATERIALS AND METHODS: Retrospectively reviewed the clinical data of 77 patients, who underwent RRPLD because of intractable chyluria in our institution. We mobilized the whole affected kidney in 22 patients during the operation, but only dissected the lower part in other 55 patients. Operative time, blood loss, visual analog scale (VAS) score, postoperative bed rest, postoperative hospital stay, recurrence, intraoperative and postoperative complications were compared between the two groups. RESULTS: All operation was successful, and none convert to open. The chyluria was resolved immediately after surgery. Compared with completely mobilized RRPLD (CMR), partly mobilized RRPLD (PMR) was superior in terms of operative time (132.91 ± 35.65 vs. 91.73 ± 24.14 min), blood loss (35.68 ± 8.21 vs. 25.09 ± 7.41 ml), VAS score (4.63 ± 0.44 vs. 2.34 ± 0.80), postoperative bed rest (3.36 ± 0.49 vs. 1.80 ± 0.85 days) and hospital stay (6.77 ± 1.57 vs. 4.98 ± 1.89 days). Compilations occurred in three patients in CMR group and two in PMR. Recurrence was confirmed by cystoscopy in three patients during 3-103-month follow-up, CMR group with 1 and PMR with 2. CONCLUSION: In our study, we found PMR was equally effective and safe as CMR. Moreover, it is more minimally invasive, painless and economical. Therefore, we believe it is unnecessary to completely mobilize the kidney in RRPLD for intractable chyluria.
Authors: Xu Zhang; Qing-Guo Zhu; Xin Ma; Tao Zheng; Hong-Zhao Li; Jun Zhang; Bin Fu; Bin Lang; Kai Xu; Tie-Jun Pan Journal: J Urol Date: 2005-11 Impact factor: 7.450
Authors: John Schneider; Uwais B Zaid; Benjamin N Breyer; Benjamin M Yeh; Antonio Westphalen; Fergus V Coakley; Zhen J Wang Journal: J Comput Assist Tomogr Date: 2010 Mar-Apr Impact factor: 1.826