Valentine Carl N, Barresi Roberto, Prinz Richard A
Department of General Surgery, 785 Jelke Building, Rush-Presbyterian-St. Luke's Medical Center, 1653 W. Congress Parkway, Chicago, IL 60612, USA.
Head Neck. 2002 Aug;24(8):810-3. doi: 10.1002/hed.10103.
Reoperation for recurrent thyroid cancer poses an increased risk of complications, including thoracic duct fistula. Treatment of this complication is controversial. A survey of thoracic literature reports the use of somatostatin analog, whereas no cases have reported the use of this therapy in cases arising from neck dissection.
We report a 16-year-old girl with recurrent papillary thyroid cancer who had a persistent lymphatic-cutaneous fistula develop after repeat modified left neck dissection. Despite conservative management, drainage persisted for 2 months. A regimen was begun that included TPN and injections of a somatostatin analog.
Treatment with a somatostatin analog resulted in an immediate attenuation of drainage and subsequent closure of the fistula after 16 days of treatment.
The use of somatostatin analog can increase the success of conservative management of thoracic duct fistulae.
复发性甲状腺癌再次手术会增加并发症风险，包括胸导管瘘。这种并发症的治疗存在争议。一项胸科文献调查报道了生长抑素类似物的使用情况，而未见有颈部清扫术后发生胸导管瘘使用该疗法的病例报道。
我们报告了一名16岁复发性乳头状甲状腺癌女孩，在再次行改良左侧颈部清扫术后出现持续性淋巴皮肤瘘。尽管采取了保守治疗，但引流持续了2个月。开始了包括全胃肠外营养（TPN）和注射生长抑素类似物的治疗方案。
生长抑素类似物治疗使引流立即减少，并在治疗16天后瘘口随后闭合。
生长抑素类似物的使用可提高胸导管瘘保守治疗的成功率。
