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目的比较改良后腹腔镜肾蒂淋巴管结扎术与传统腹腔镜手术治疗乳糜尿的临床疗效。方法回顾性分析68例行后腹腔镜肾蒂淋巴管结扎术的乳糜尿患者,其中47例行传统术式(对照组),21例行改良术式(观察组)。传统术式在肾包膜外完全剥离整个肾脏后行肾固定术,改良术式为肾门水平以上肾周不作游离、不行肾固定。比较两组手术时间、出血量等术中情况,以及术后并发症、住院时间、随访结果等术后情况。结果对照组腹腔镜下成功完成46例,1例中转开放,观察组21例均顺利完成。两组术中均无大血管及周围组织损伤,观察组手术时间较组缩短(P<0.05),两组术中出血量比较无统计学差异。术后对照组2例出现乳糜漏,1例出现尿漏;观察组1例出现乳糜漏;观察组术后住院时间较对照组缩短(P<0.05)。随访42~119个月,两组术侧尿乳糜定性实验均为阴性,均无复发及肾下垂,所有患者营养状况改善。结论改良的后腹腔镜肾蒂淋巴管结扎术疗效与传统术式相当,其不需游离整个肾脏,不行肾固定术,具有简化操作、减小创伤、缩短患者手术时间及住院时间等优点。 [ABSTRACT FROM AUTHOR]