Summary and prospects of fourteen years' experience with treatment of chyluria by microsurgery.

ABSTRACT

Since 1974, 125 cases of chyluria have been treated at our hospital using a microsurgical technique. The duration of illness was longer than 1 year in 94% of the cases. For male patients (95 cases), lymphaticovenous anastomosis was performed at the inguinal part of the spermatic cord and, for females (30 cases), at 3 different regions of the lower extremities, namely dorsum of foot, anterior aspect of leg and anterior aspect of thigh. Most of the patients in our series were followed for 6 months to 4 years (the longest 14 years). Among them, 59 cases were followed for more than 1 year. In 45 patients the urine was completely free from chyle (76.3%), and in 4 other patients the urine was weakly chyle positive or they had occasional mild attacks. The total effect rate was 83.1% (45 of 59). Lymphatic fistulae in the kidney did not close immediately after anastomosis, so chyluria persisted for variable periods in most cases, usually not longer than 6 months. In the surgical treatment of chyluria, lymphaticovenous anastomosis, undertaken at a superficial part of the body, was probably the operation of choice because of less damage, little postoperative morbidity and rare serous complications.