Zhao W P, Hou L Q, Shen J L
Department of Urology, Huashan Hospital, Shanghai Medical University, People's Republic of China.
Eur Urol. 1988;15(3-4):219-22.
Since 1974, 125 cases of chyluria have been treated at our hospital using a microsurgical technique. The duration of illness was longer than 1 year in 94% of the cases. For male patients (95 cases), lymphaticovenous anastomosis was performed at the inguinal part of the spermatic cord and, for females (30 cases), at 3 different regions of the lower extremities, namely dorsum of foot, anterior aspect of leg and anterior aspect of thigh. Most of the patients in our series were followed for 6 months to 4 years (the longest 14 years). Among them, 59 cases were followed for more than 1 year. In 45 patients the urine was completely free from chyle (76.3%), and in 4 other patients the urine was weakly chyle positive or they had occasional mild attacks. The total effect rate was 83.1% (45 of 59). Lymphatic fistulae in the kidney did not close immediately after anastomosis, so chyluria persisted for variable periods in most cases, usually not longer than 6 months. In the surgical treatment of chyluria, lymphaticovenous anastomosis, undertaken at a superficial part of the body, was probably the operation of choice because of less damage, little postoperative morbidity and rare serous complications.
自1974年以来，我院采用显微外科技术治疗了125例乳糜尿患者。94%的病例病程超过1年。男性患者（95例）在精索腹股沟部进行淋巴管静脉吻合术，女性患者（30例）在下肢3个不同部位，即足背、小腿前侧和大腿前侧进行手术。我们系列中的大多数患者随访了6个月至4年（最长14年）。其中，59例随访超过1年。45例患者尿液完全无乳糜（76.3%），另外4例患者尿液呈弱阳性或偶尔有轻度发作。总有效率为83.1%（59例中的45例）。肾淋巴管瘘在吻合术后不会立即闭合，因此大多数情况下乳糜尿会持续不同时间，通常不超过6个月。在乳糜尿的外科治疗中，在身体浅表部位进行的淋巴管静脉吻合术可能是首选手术，因为损伤小、术后发病率低且很少发生浆液性并发症。
