The efficacy and safety of retroperitoneoscopic renal pedicle ligation of lymphatic disconnection versus open surgery in the treatment of chyluria: A systematic review and meta-analysis .

Objective: The current meta-analysis was performed to evaluate the safety and efficacy of retroperitoneoscopic renal pedicle ligation of lymphatic disconnection (RRPLD) compared with open surgery (OS) in the treatment of chyluria.

Materials And Methods: Relevant studies were retrieved from MEDLINE, EMBASE, -SCOPUS, the Cochrane library and two Chinese literature database resources (Wanfang and CNKI) in March 2016. All eligible studies comparing RRPLD with OS for chyluria were included in this study. The main outcome including operative time, blood loss, postoperative (PO) intestinal recovery time, PO drainage duration, PO hospital stay, PO time of returning to work, PO bed time, and complications as well as rate of recurrence for RRPLD and OS were pooled using the Revman software.

Results: Twelve studies with a total of 620 patients were included in this meta-analysis. Of these patients, 365 and 255 had undergone renal pedicle lymphatic ligation via RRPLD and OS, respectively. There were significant reductions in operative time, PO intestinal recovery time, PO drainage duration, PO hospital stay, PO time of returning to work, and possible reductions in intraoperative blood loss intraoperative and PO complications for RRPLD compared to OS. However, other outcome variables, such as PO time in bed and PO recurrence, were not found to be statistically significant for either group.

Conclusion: Compared with OS, RRPLD has several advantages such as shorter operative time, less intraoperative blood loss, and lower incidence of complications. Thus, it may be an efficacious and safe therapeutic modality for chyluria.