Comparative Study Of High Intensity Focused Ultrasound (HIFU) And Retroperitoneoscopy Renal Pedicle Lymphatic Vessels Disconnection In Treating Filarial Chyluria

ObjectivesTo evaluate the value and security of high intensity focused ultrasound(HIFU) in treating filarial chyluria and to compare with retroperitoneoscopy renal pedicle lymphatic vessels disconnection in clinical useMethodsSixty filarial chyluria patients of our hospital were collected from 2001 to 2006.Thirty cases of group A were treated by HIFU. Thirty cases of group B were treated by retroperitoneoscopy renal pedicle lymphatic vessels disconnection.The cure rate,recurrence rate,side effects,length of stay, expenditure of treatment,renal function and renal artery inner diameter of pretreatment and posttreatment ,resistant index and nephrogram of pretreatment and posttreatment are calculated and analyzed to evaluate the feasibility and security of HIFU in treating filarial chyluria and the advantages and disadvantages of the two methods respectively.Results1.Twenty three cases in the group A were cured,7 cases were ineffective,cure rate was 76.67%.All of 30 cases in the group B were cured , cure rate was 100%.The cure rate of group B was higher than that of group A(X2=5.82,P<0.05).2.Four of 23 cured patients in the group A recurred,recurrence rate was 17.39%.1 of 30 cured patients in the group B recurred, recurrence rate was 3.33%,which had no significant difference among them(X2=1.59,P>0.05).3.The figure of Cr, renal artery inner diameter, resistant index of pretreatment and posttreatment in both of the two groups have no significant difference(both P>0.05).4. The length of stay of group A and B has significant difference(t=2.853,P<0.01),the expenditure of treatment also has significant difference(t=2.976,P<0.01).Both length of stay and expenditure of treatment of HIFU treatment are less than those of retroperitoneoscopy operation treatment.5.Part of patients in the group A emerged pain of therapy area in the course of treatment,the pain could be vanished or lightened obviously after proper adjustment.Two cases emerged skin redness of therapy area,which was vanished 2 days later.No other complications occurred in the course of and after treatment.ConclusionsHigh intensity focused ultrasound can be used for the treatment of filarial chyluria,it does no harm to renal function and vessel of renal and has advantages of high security , but it has some recurrence rate . Compared with operation treatment,although cure rate is slightly lower, it has advantages of non- invasion ,shorter time of therapy and fewer expenditure of therapy. It especially refer to the patients who are old or physically weak and have obvious surgical contraindications.In addition,recurring patients of posttreatment can be treated repeatedly.Both of the two treatment methods have advantages and disadvantages,they can supplement each other.