title: It is unnecessary to completely mobilize the kidney in retroperitoneoscopic renal pedicle lymphatic disconnection for intractable chyluria.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.affiliation: Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Jinyou
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China. wizard_zt1982@163.com.
authors.forename: Dexin
authors.initials: D
authors.lastname: Yu
authors.affiliation: Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Jiaxing
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Haoqiang
authors.initials: H
authors.lastname: Shi
authors.affiliation: Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Liangkuan
authors.initials: L
authors.lastname: Bi
authors.affiliation: Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Dongdong
authors.initials: D
authors.lastname: Xie
authors.affiliation: Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Min
mesh_terms: D002681:China; D002913:Chyle / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D042601:Lymphatic Vessels / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D012187:Retroperitoneal Space; D016896:Treatment Outcome; D014548:Urinary Fistula / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D014556:Urine; D014570:Urologic Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods
keywords: Chyluria; Renal pedicle lymphatic disconnection; Retroperitoneoscopy; Treatment