Intractable chyluria : experience of 314 cases in a single center in China

This study aimed to retrospectively evaluate the clinical outcomes of 317 patients with intractable chyluria and present our experience with conservative and surgical management of intractable chyluria by different approaches. From September 2004 to June 2013, 314 patients with chyluria (133 men and 181 women) were recruited at our center. Instillation of povidone iodine (0.2%) was used for 46 patients. 53 patients with chyluria underwent renal pedicle lymphatic disconnection (RPLD) via the retroperitoneoscopic and conventional open approaches. 42 (91.3%) patients showed immediate clearance and chyluria recurred in 14 patients (33.3%). Retroperitoneoscopic renal pedicle lymphatic disconnection (RRPLD) or open surgery was performed successfully in all patients. With regard to operative time, intraoperative blood loss, postoperative intestinal recovery and hospital stay, retroperitoneoscopy was superior to conventional open surgery. Simplified RRPLD has the advantages of shorter operative time, shorter postoperative bed stay, shorter postoperative hospital stay and less pain while it does not significantly increase the recurred risk of chyluria at the same time compared with Standardized RRPLD and Modified RRPLD. In cconclusion, single dose of 0.2% povidone iodine sclerotherapy is safe and effective treatment for chyluria. RRPLD can achieve the same clinical efficacy as open surgery and Simplified RRPLD is a feasible and effective surgical procedure for chyluria.