Retroperitoneoscopic renal pedicle lymphatic disconnection for chyluria.
OBJECTIVE
To report our experiences in retroperitoneoscopic renal pedicle lymphatic stripping for chyluria.


METHODS
Six cases of filarial chyluria were admitted to our hospital from November 2001 to June 2002. Of these cases, 4 were men and 2 women, with age ranging from 34 to 52 years (mean, 42 years). Diagnosis was made by using urine test for the presence of chyle and fat globule, cystoscopy, excretory urogram and retrograde pyelography. Chyluria was found on the left renal unit in 2 cases and on the right side in 4 cases. The technique of retroperitoneoscopic management of chyluria consisted of nephrolympholysis, hilar vessel stripping and ureterolympholysis.


RESULTS
Operative time ranged from 69 to 120 minutes (mean, 95 minutes). Intraoperative blood loss was 50-180 ml (mean, 85 ml). Chyluria disappeared in all patients immediately after operation. Mild hematuria occurred in 4 cases within 12 hours and disappeared at 24 hours. Subcutaneous emphysema around the lesions was found in 2 cases and was spontaneously absorbed 3 days after the treatment. There was no lymphatic leak at the lesions. The patients were discharged from the hospital 5-9 days after the treatment. All patients gained weight and their haemoglobin and serum protein increased by 13.5 g/L and 3.66 g/L respectively. No chyluria recurrence was reported during 1-1.6 years follow-up.


CONCLUSIONS
Retroperitoneoscopic renal pedicle lymphatic disconnection for chyluria is a safe, effective and efficient surgical procedure with minimal invasion, less pain, lower morbidity, short hospital stay and rapid recovery.
Jiang
Jun
J
Department of Urology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, China.
Zhu
Fangqiang
F
Jin
Fengshuo
F
Jiang
Qing
Q
Wang
Luofu
L
D000328:Adult; D002913:Chyle; D004724:Endoscopy; D006801:Humans; D008206:Lymphatic Diseases / Q000601:surgery*; D008208:Lymphatic System / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012187:Retroperitoneal Space; D014556:Urine