Robotic surgery for treatment of chyluria

Barman, Naman; Palese, Michael

doi:10.1007/s11701-016-0560-5

Cited by 7 publications

(3 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Due to a large loss of protein and fat in the urine, non-parasitic chyluria patients often present with hypoproteinemia, malabsorption, general fatigue, and weight loss. In addition, some patients may experience ipsilateral flank pain, frequent urination, urinary tract infection, and urinary retention symptoms ( 15 , 17 , 18 ). Up to now, targeted treatments for chyluria mainly include conservative treatments and surgery.…”

Section: Discussionmentioning

confidence: 99%

Renal pedicle lymphatic ligation for non-parasitic chyluria via retroperitoneal laparoscopic surgery: a single-center 12-year experience

Wang,

Li,

Zhu

et al. 2023

Transl Androl Urol

View full text Add to dashboard Cite

Background Chyluria is a rare disease in which chylous is excreted in the urine. Currently, management of chyluria includes conservative treatments and surgical measures. This study aimed to report our experience in treating non-parasitic chyluria with retroperitoneal laparoscopic ligation of the renal lymphatic vessels. Methods Data from 52 patients who underwent retroperitoneoscopic ligation of the renal lymphatic vessels for non-parasitic chyluria between December 2009 and May 2022 were reviewed. After general anesthesia, the patients were passively placed in the healthy lateral decubitus position and underwent three-port retroperitoneal laparoscopy. Detailed medical data, including demographic characteristics, intraoperative outcomes, postoperative data, and complications, were reviewed. Results Fifty-two patients received surgery treatment at our institution. The mean disease course was 89.3 months. The mean age was 58.8 years, with females accounting for 57.7% (30/52); the majority of patients (33/52) had the laterality of chyluria on the left and 9 (17.3%) had a history of previous thoracic or abdominal surgery. Compared with the urine and blood data before the operation and on the first day after the operation, urinary protein, urinary tract infection, urinary red blood cells, hemoglobin, albumin, and serum total protein significantly improved 3 months after the operation. However, there were no significant differences in blood creatinine and blood urea nitrogen levels among the three groups. The mean surgery time was about 110.0 minutes, and the estimated total blood loss was 81.2 mL. The postoperative drainage volume was 229.9 mL. The average time to start a liquid diet and to be out of bed were 1.5 and 1.9 days, respectively. Transient postoperative gross hematuria occurred in eight patients, and complications occurred in five patients after surgery. The mean length of hospitalization was 6.6 days. The follow-up duration ranged from 3 to 152 months, and except for three patients who did not respond to treatment, the remaining patients had no recurrence and did not require reoperation. Conclusions Our long-term follow-up results showed that renal pedicle lymphatic ligation via retroperitoneal laparoscopic surgery is an effective, safe, and reliable surgical option for patients with non-parasitic chyluria.

show abstract

Section: Discussionmentioning

confidence: 99%

Renal pedicle lymphatic ligation for non-parasitic chyluria via retroperitoneal laparoscopic surgery: a single-center 12-year experience

Wang,

Li,

Zhu

et al. 2023

Transl Androl Urol

View full text Add to dashboard Cite

show abstract

“…We wanted to describe this case by highlighting all the steps as describing a diagnostic-therapeutic path because, in fact, there is nothing in the literature, since it is a very rare case: an "idiopathic chyluria", resistant to all the attempts described in the literature of "best conservative treatment" such as alipidic parenteral feeding and continuous drainage of the upper and lower urinary tract and resolved with "radical" surgery of the retroperitoneum. The extensive para-aortic, retroaortic and entire interaortocaval lymphadenectomy, intraperitonealization of the kidney and ureter and their complete covering with a large, vascularized flap of omentum has brought together the three isolated ways described in the literature to solve cases of chyluria even with laparoscopic or robotic minimally invasive techniques [9,10]. We wanted to resort to this complex "radical" surgery "open" technique for the severity of the case described, for the long duration of the pathology and to reduce to a minimum the recurrence that weighs, even if in a low percentage, on the other techniques adopted in isolation.…”

Section: Discussionmentioning

confidence: 99%

“Non-Parasitic” and “Non-Iatrogenic” Chyluria: Its Diagnosis and Treatment

Rinaldi¹,

Prontera²,

Grossi³

et al. 2021

SCR

View full text Add to dashboard Cite

Chyluria occurs in all its forms with milky urine, recurrent episodes of acute urinary retention, left renal colic and proteinuria. In non-parasitic or iatrogenic diseases, it is secondary to communicate between the cisterna system of the chyli and the lymphatics of the calyx system of the left urinary tract with a retrograde passage of a kilo and its appearance in the urine which therefore take on a milky appearance [1, 2]. Sometimes, episodically, especially after the ingestion of a high-fat meal, the quantity of kilo is so abundant that it can cause obstruction of the upper urinary tract and of the bladder, resulting in renal colic or acute urinary retention that may require their unblocking with double J stent or bladder catheter [3, 4]. After conservative attempts with a fat-free diet or with the parenteral diet, in case of their failure, surgery must be performed by performing a para-aortic and renal hilum lymphadenectomy and, in severe cases, with intraperitonealization of the kidney and left ureter. This is the case of the patient reported below and successfully treated recently with an innovative “open” surgical technique.

show abstract

“…Retroperitoneoscopic RRPLD for chyluria completely ligates the lymphatic vessels and is a safe, effective and efficient surgical procedure with minimal invasion, less pain, less blood loss, lower morbidity, short hospital stay and rapid recovery (63). A robotic approach was recently described by Barman et al in 2016 (64): a right robotic ureterolysis, renal hilar dissection and intraperitonealization of the ureter was performed in a 75-year-old man with persistent chyluria. No intra and peri-operative complications were described and chyluria was not present at last follow-up.…”

Section: Managementmentioning

confidence: 99%

Chyluria: The State of the Art

et al. 2017

View full text Add to dashboard Cite

Chyluria is the passage of chyle in the urine. The cause seems to be the rupture of retroperitoneal lymphatics into the pyelocaliceal system, giving urine a milky appearance. This communication is caused by the obstruction of lymphatic drainage proximal to intestinal lacteals, resulting in dilatation of distal lymphatics and the eventual rupture of lymphatic vessels into the urinary collecting system.This condition, if left untreated, leads to significant morbidity because of hematochyluria, recurrent renal colic, nutritional problems due to protein losses and immunosuppression resulting from lymphocyturia.In this review, we summarize the state of the art of this condition and the newest treatments available.

show abstract

Robotic surgery for treatment of chyluria

Cited by 7 publications

References 18 publications

Renal pedicle lymphatic ligation for non-parasitic chyluria via retroperitoneal laparoscopic surgery: a single-center 12-year experience

Renal pedicle lymphatic ligation for non-parasitic chyluria via retroperitoneal laparoscopic surgery: a single-center 12-year experience

“Non-Parasitic” and “Non-Iatrogenic” Chyluria: Its Diagnosis and Treatment

Chyluria: The State of the Art

Contact Info

Product

Resources

About