Study And Comparison Between The Renal Pedicle Lymphatic Ligation With The Single-Site Retroperitoneoscopy And The Traditional Retroperitoneoscopy To Treat Chyluria

Objective: Through retrospective analysis of clinical data of chyluria patients whomhad renal pedicle lymphatic ligation with the single-site retroperitoneoscopy and thetraditional retroperitoneoscopy, the safety and feasibility of the renal pedicle lymphaticligation with the single-site retroperitoneoscopy were explored, as well as its clinicalvalue was evaluated in this paper.Method: The clinical data of34cases of chyluria patients during June2011to Nov.2012was retrospectively analyzed, in which14cases (A group) were taken renalpedicle lymphatic ligation with the single-site retroperitoneoscopy and20cases (Bgroup) were taken pedicle lymphatic ligation with the traditional retroperitoneoscopy.The clinical data related to the operation of the two groups of patients was recorded,including gender, age, body mass index, operative time, intraoperative blood loss,operative complications, postoperative drainage volume, postoperative anal exhausttime, postoperative ambulation time, postoperative pain evaluation, postoperativehospital stay, length of the operative incision, satisfaction scores of incision andfollow-up situation, and the above data were statistically analyzed.Result: The two groups were successfully operated, and1case of the single-siteretroperitoneoscopy group needed a additional trocar. The comparison between the data ofthe two groups can be seen: the operative time of the two groups are130.28±18.56,92.43±24.12min respectively; the intraoperative estimated blood loss volume are 70.98±8.94,67.80±8.78mL respectively; the complications of the two groups showedthat the single-hole retroperitoneoscopy group has2cases of peritoneal injury, nosubcutaneous emphysema,1case of hypercapnia and3cases of postoperativehematuria and the traditional retroperitoneoscopy group has1case of vascular injury,1case of peritoneal injury,2cases of subcutaneous emphysema,2cases of hypercapniaand5cases of postoperative hematuria; the postoperative drainage volumes are31.63±18.15,30.08±10.20ml respectively; the postoperative anal exhaust time are2.26±0.68d,2.13±0.76d respectively; the postoperative ambulation time are3.36±0.74,3.42±0.83d respectively; the VAS pain scores first day after operation are3.35±1.35,4.53±0.95respectively; the postoperative hospital stays are8.63±1.72,8.38±1.61d; the lengths of the operative incision are3.58±0.24,5.32±0.42cmrespectively; the satisfaction scores of incision are9.21±0.32,7.21±2.13respectively;the two groups were followed up for3-18months that no case of recurrence ofoperated side kidney and long-term complications.There were no difference between the two groups in terms of gender, age, bodymass index (p>0.05). The A group is better than B group in terms of length of operativeincision, postoperative VAS pain scores and satisfaction scores of incision, and therehas statistical significance between the two groups (p<0.05); the operative time of Agroup is longer than that of B group (p<0.05); there has no significant differencebetween the intraoperative blood loss volumes, postoperative complications,postoperative drainage volumes, postoperative anal exhaust times, postoperativeambulation time and postoperative hospital stay of the two groups (p>0.05).Conclusion: The renal pedicle lymphatic ligation with the single-siteretroperitoneoscopy is safe and feasible, which has quite similar efficacy with thestandard retroperitoneoscopy, meanwhile it can reduce the postoperative pain ofpatients and get better cosmetic effect for incision; however, the single-siteretroperitoneoscopy also has disadvantages including crowded intraoperative instruments, narrow operating space and difficult operation. Accumulation of operationexperience and promotion of single-site laparoscopy special instruments can reduceoperation time and shorten the learning curve.