Fujiwara Y, Nakagawa K, Kusunoki M, Hatada T, Yamamura T, Utsunomiya J
Second Department of Surgery, Hyogo College of Medicine, Japan.
Hepatogastroenterology. 1999 Jan-Feb;46(25):290-4.
Chylothorax is an uncommon but well recognized complication of esophagectomy. We present the case of a 57 year-old man with squamous cell carcinoma of the abdominal esophagus who underwent subtotal esophagectomy by right thoracotomy. Post-operatively, the volume of pleural effusion from the right chest was increased (1600-2000 ml/day). The effusion was straw colored, not changing to milky after meals. The characteristics and composition of the pleural fluid were similar to those of chyle. We therefore treated this patient using methods for treatment of chylothorax, conservatively, by administration of OK-432 and minocycline/hydrochloride into the pleural cavity from the chest tube with success. We discuss the pathophysiology of this unusual condition and its treatment.
乳糜胸是食管癌切除术后一种罕见但已被充分认识的并发症。我们报告一例57岁男性，患有腹段食管鳞状细胞癌，通过右胸切口接受了食管次全切除术。术后，右侧胸腔的胸腔积液量增加（1600 - 2000毫升/天）。积液呈稻草色，餐后不变为乳白色。胸水的特征和成分与乳糜相似。因此，我们采用治疗乳糜胸的方法对该患者进行保守治疗，通过胸管向胸腔内注入沙培林和盐酸米诺环素，取得了成功。我们讨论了这种罕见病症的病理生理学及其治疗方法。
