Abstract
Introduction: The aim of this study was to compare the efficacy and safety of two surgical procedures, namely, retroperitoneal laparoscopic simple renal pedicle lymphatic ligation and retroperitoneal laparoscopic perirenal lymphatic ligation, by evaluating the effectiveness and safety of the former. Methods: A retrospective analysis was conducted on the clinical data of 330 patients with chyluria who underwent laparoscopic simple renal pedicle lymphatic ligation (group A, 92 cases) and laparoscopic perirenal lymphatic ligation (group B, 238 cases) at the First Affiliated Hospital of Nanchang University from January 2011 to September 2023. The surgical duration, intraoperative blood loss, postoperative hospital stay, postoperative drainage tube placement time, perioperative complications, long-term postoperative complications, and recurrence were compared between the two groups, the follow-up period ranged from 12 to 164 months. Results: All 330 surgeries were completed without any cases requiring conversion to open surgery. Compared to group B, group A was associated with a significant reduction in both postoperative hospitalization duration (6.00 days vs. 7.00 days, p < 0.05) and surgical duration (112.50 min vs. 140.00 min, p < 0.001). Furthermore, group A demonstrated a markedly lower incidence of perioperative complications (5.43% vs. 13.45%, p < 0.05) and reported no cases of late complications (0% vs. 4.62%, p < 0.05). No significant intergroup differences were observed in intraoperative blood loss, time to drainage tube removal, or recurrence rates, indicating that patients in group A recovered faster and had fewer complications were achieved without compromising other safety and efficacy metrics. Multivariate logistic regression analyses revealed that the surgical approach demonstrated a consistent protective effect by significantly reducing both perioperative and long-term complications. Furthermore, a specific laterality (right) were associated with a significantly reduced risk of perioperative complications. Disease duration was identified as an independent risk factor for perioperative complications. In terms of recurrence, albumin level served as the only significant protective factor. Conclusion: Retroperitoneal laparoscopic simple renal pedicle lymphatic ligation can shorten the operation time and postoperative hospitalization time, and reduce the occurrence of postoperative complications. Compared with retroperitoneal laparoscopic perirenal lymphatic ligation, this method has less trauma, faster recovery, and fewer complications. It is an improved surgical approach that benefits both doctors and patients.
