title: Comparison of open surgery versus retroperitoneoscopic approach to chyluria.
abstract: OBJECTIVE
  We compared the clinical effectiveness of renal pedicle lymphatic disconnection for chyluria performed by retroperitoneoscopy and by open surgery.
  
  
  METHODS
  Three male and 4 female patients 33 to 68 years old (mean age 49) with chyluria underwent retroperitoneoscopic renal pedicle lymphatic disconnection. Chyluria was on the left side in 5 cases and on the right side in 2. Open renal pedicle lymphatic disconnection was performed in 4 men and 2 women 33 to 61 years old (mean age 45.8). Chyluria was on the left and right sides in 3 cases each. Mean operative time, intraoperative blood loss, postoperative intestinal function recovery time, intraoperative and postoperative complications, postoperative hospital delay and operative outcome were compared in these 2 groups.
  
  
  RESULTS
  Compared with the open surgery group results in the retroperitoneoscopic group were superior in terms of operative time (42 to 90 minutes, mean +/- SD 65.0 +/- 18.8 versus 120 to 220, mean 156.7 +/- 38.8), intraoperative blood loss (20 to 50 ml., mean 29.3 +/- 10.2 versus 60 to 250, mean 171.7 +/- 76.5), postoperative intestinal function recovery time (24 to 48 hours, mean 36.0 +/- 6.9 versus 24 to 72, mean 54.0 +/- 21.1), intraoperative and postoperative complications, and postoperative hospital stay (3 to 6 days, mean 4.7 +/- 0.7 versus 7 to 9 days, mean 7.8 +/- 1.0). In the open surgery group primary anastomosis was performed in 1 case due to injury to a renal artery branch during the operation. Chyluria resolved the day after surgery in the 2 groups. No obvious complications developed postoperatively. The followup of 2 to 12 months (mean 6.7 +/- 4.0) showed no recurrence of chyluria.
  
  
  CONCLUSIONS
  Retroperitoneoscopic renal pedicle lymphatic disconnection completely ligates the lymphatic vessels with minimal invasion, less blood loss, rapid recovery and a good short-term outcome.
authors.affiliation: Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
authors.forename: Zhang-Qun
authors.initials: ZQ
authors.lastname: Ye
authors.forename: Zhong
authors.initials: Z
authors.lastname: Chen
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Chen
authors.forename: Qing-Guo
authors.initials: QG
authors.lastname: Zhu
authors.forename: Ma
authors.initials: M
authors.lastname: Xin
authors.forename: Long-Cheng
authors.initials: LC
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D002913:Chyle / Q000469:parasitology; D004605:Elephantiasis, Filarial / Q000150:complications / Q000652:urine; D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D008026:Ligation; D008208:Lymphatic System / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014556:Urine; D013520:Urologic Surgical Procedures / Q000379:methods*