Evaluation of Cervical Thoracic Duct Exploration in Idiopathic Chyluria: A Retrospective Comparative Study.

IF 2.4 Q2 UROLOGY & NEPHROLOGY

Research and Reports in Urology Pub Date : 2025-10-22 eCollection Date: 2025-01-01 DOI:10.2147/RRU.S532806

Jianfeng Xin, Chao Dong, Song Xia, Yuguang Sun, Jian Dong, Kun Chang, Wanchun Su, Kun Hao, Youlei Qian, Wenbin Shen

{"title":"Evaluation of Cervical Thoracic Duct Exploration in Idiopathic Chyluria: A Retrospective Comparative Study.","authors":"Jianfeng Xin, Chao Dong, Song Xia, Yuguang Sun, Jian Dong, Kun Chang, Wanchun Su, Kun Hao, Youlei Qian, Wenbin Shen","doi":"10.2147/RRU.S532806","DOIUrl":null,"url":null,"abstract":"Purpose: The purpose of this study is to evaluate a novel surgical method for idiopathic chyluria.Methods: Data from 63 patients with idiopathic chyluria who underwent direct lymphangiography (DLG) were retrospectively analyzed. Of these, 50 patients received cervical thoracic duct exploration (CTDE) as a treatment, while 13 were managed with a low-fat diet. The treatment efficacy of the two groups was compared, and a univariate analysis of the CTDE treatment effect was performed.Results: DLG revealed that the contrast agent passed upwards and outwards through paravertebral lymphatics into the region of the renal hilum and pelvis (left: 38.10%; right: 33.33%; bilateral: 28.57%). Dilatation of retroperitoneal lymphatics was found in 90.47% of cases. Additionally, 47.6% of patients demonstrated contrast agent reflux into lymphatic trunks in the neck (the percentage of contrast agent reflux to the jugular trunk, subclavian trunk, and broncho-mediastinal trunk being 28.57%, 38.09%, and 6.34%, respectively). The effective rate in the CTDE group was higher than in the low-fat diet group (χ² = 5.893, p=0.015). Univariate analysis of the patients who underwent CTDE demonstrated that younger age (p=0.036) and Grade III chyluria were risk factors for ineffective treatment, while patients with Grade I had better treatment outcomes (p=0.029).Conclusion: Obstruction of the cervical thoracic duct may be a significant cause of idiopathic chyluria. Alleviating this obstruction may be an effective treatment strategy for idiopathic chyluria.","PeriodicalId":21008,"journal":{"name":"Research and Reports in Urology","volume":"17 ","pages":"437-447"},"PeriodicalIF":2.4000,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12554261/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Research and Reports in Urology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/RRU.S532806","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: The purpose of this study is to evaluate a novel surgical method for idiopathic chyluria.

Methods: Data from 63 patients with idiopathic chyluria who underwent direct lymphangiography (DLG) were retrospectively analyzed. Of these, 50 patients received cervical thoracic duct exploration (CTDE) as a treatment, while 13 were managed with a low-fat diet. The treatment efficacy of the two groups was compared, and a univariate analysis of the CTDE treatment effect was performed.

Results: DLG revealed that the contrast agent passed upwards and outwards through paravertebral lymphatics into the region of the renal hilum and pelvis (left: 38.10%; right: 33.33%; bilateral: 28.57%). Dilatation of retroperitoneal lymphatics was found in 90.47% of cases. Additionally, 47.6% of patients demonstrated contrast agent reflux into lymphatic trunks in the neck (the percentage of contrast agent reflux to the jugular trunk, subclavian trunk, and broncho-mediastinal trunk being 28.57%, 38.09%, and 6.34%, respectively). The effective rate in the CTDE group was higher than in the low-fat diet group (χ² = 5.893, p=0.015). Univariate analysis of the patients who underwent CTDE demonstrated that younger age (p=0.036) and Grade III chyluria were risk factors for ineffective treatment, while patients with Grade I had better treatment outcomes (p=0.029).

Conclusion: Obstruction of the cervical thoracic duct may be a significant cause of idiopathic chyluria. Alleviating this obstruction may be an effective treatment strategy for idiopathic chyluria.

Abstract Image

查看原文本刊更多论文

颈胸导管探查治疗特发性乳糜尿的回顾性比较研究。

目的：本研究的目的是评估一种治疗特发性乳糜尿的新手术方法。方法：回顾性分析63例接受直接淋巴管造影（DLG）的特发性乳糜尿患者的资料。其中，50例患者接受颈胸导管探查（CTDE）治疗，13例患者采用低脂饮食。比较两组治疗效果，对CTDE治疗效果进行单因素分析。结果：DLG显示造影剂经椎旁淋巴管向上向外进入肾门及肾盂区（左：38.10%；右：33.33%；双侧：28.57%）。腹膜后淋巴管扩张占90.47%。此外，47.6%的患者表现出对比剂反流到颈部淋巴干（对比剂反流到颈静脉干、锁骨下干和支气管纵隔干的比例分别为28.57%、38.09%和6.34%）。CTDE组有效率高于低脂饮食组（χ²= 5.893,p=0.015）。对CTDE患者的单因素分析显示，年龄较小（p=0.036）和III级乳糜尿是治疗无效的危险因素，而I级乳糜尿患者的治疗效果较好（p=0.029）。结论：颈胸导管阻塞可能是特发性乳糜尿的重要原因。减轻这种阻塞可能是特发性乳糜尿的有效治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Research and Reports in Urology UROLOGY & NEPHROLOGY-

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

16 weeks

期刊介绍： Research and Reports in Urology is an international, peer-reviewed, open access, online journal. Publishing original research, reports, editorials, reviews and commentaries on all aspects of adult and pediatric urology in the clinic and laboratory including the following topics: Pathology, pathophysiology of urological disease Investigation and treatment of urological disease Pharmacology of drugs used for the treatment of urological disease Although the main focus of the journal is to publish research and clinical results in humans; preclinical, animal and in vitro studies will be published where they will shed light on disease processes and potential new therapies. Issues of patient safety and quality of care will also be considered.