乳糜尿症の腎周囲リンパ管遮断術について(特にSkyBlueの使用経験について)

Abstract

Up to the present, many investigations of therapy of chylur i a such as medicinal treatment or peripelvic administration of medicine solutions resulted in not so good effects. Both the histological demonstration of generating mechanism that the ch y luria is caused by the direct opening of lymphatic canals to calyx or pelvis and the success of perirenal lymphectomy by Katamine, Okamoto, etc. recommend the operative treatment, however, the problem of recurrence or of urinary protein is remaining. By simultaneous use of Sky blue with the perirenal lym p hectomy which is usually performed to chyluria by authors, the separation and severance of all lymphatic canals near the kidney or the kidney stalk becomes more exactly because the Sky blue stains the lymphatic canals. In this me t h od, when about 3 to 5 cc Sky blue are slightly injected into subserous cavity of pelvis by the needle for intracutaneous tuberculin injection, a large number of net- or strand-like lymphatic canals encircling the ureter, blood vessels at the capsula and the stalk of the kidney are closed up and this fact makes easy to carry out the severance of lymphatic canals completly. And the fact recu r rence or the postoperative appearance of urinary protain could not be obserbed showes the exact blocking of perirenal lymphatic canals and probably gives the important support to the Hayashi's or Kume's excretion theory which agreed by the present authors. The u se of Sky blue, should be approved.