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肾部分切除术后乳糜尿:一种罕见但严重的并发症。

Chyluria after partial nephrectomy: a rare but considerable complication.

机构信息

Department of Urology, Fujisawa City Hospital, Fujisawa, Kanagawa, Japan.

出版信息

Int J Urol. 2013 Feb;20(2):242-5. doi: 10.1111/j.1442-2042.2012.03139.x. Epub 2012 Sep 3.

Abstract

An 82-year-old male patient underwent open left lower-pole partial nephrectomy with a microwave tissue coagulator (Microtaze). Pathological findings showed clear cell renal cell carcinoma, pT1a, Fuhrman grade 2 with negative margins. Then 2 years later, he presented with urinary retention. His urine appeared cloudy and milky only after meals, but appeared normal at other times. He was diagnosed with chyluria after partial nephrectomy. Endoscopic sclerotherapy with silver nitrate was carried out, because his serum albumin decreased to 3.4 g/dL within 3 months. He had an uneventful postoperative course. His chyluria completely disappeared and has not recurred for 11 months. Although chyluria after nephrectomy is very rare, there is a possibility that the frequency of chyluria after partial nephrectomy might increase, because the number of partial nephrectomies continues to increase worldwide. We herein summarize this rare surgical complication and discuss the effectiveness of endoscopic sclerotherapy as a therapeutic tool.

摘要

一位 82 岁男性患者接受了微波组织凝固器(Microtaze)辅助的开放性左肾下极部分切除术。病理检查结果显示为透明细胞肾细胞癌,pT1a,Fuhrman 分级 2 级,切缘阴性。2 年后,他出现了尿潴留。他的尿液只有在饭后才会变得混浊和乳白色,但其他时间则正常。他被诊断为肾部分切除术后乳糜尿。由于他的血清白蛋白在 3 个月内降至 3.4g/dL,因此进行了内镜下硬化治疗。他术后恢复顺利。他的乳糜尿完全消失,且 11 个月未复发。尽管肾切除术后乳糜尿非常罕见,但由于全世界部分肾切除术的数量不断增加,部分肾切除术术后乳糜尿的发生频率可能会增加。我们在此总结这一罕见的手术并发症,并讨论内镜下硬化治疗作为一种治疗工具的有效性。

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