Liu Chin-Su, Tsai Hsin-Lin, Chin Tai-Wai, Wei Chou-Fu
Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2005 May;68(5):234-6. doi: 10.1016/S1726-4901(09)70214-X.
Four pediatric cases of chylothorax after cardiothoracic surgery, which were managed surgically, are reviewed retrospectively. All patients underwent right thoracotomy and mass ligation of the right thoracic duct without detecting the true site of leakage. Although 1 patient died from heart failure the day after operation, the other 3 recovered quickly without sequelae. Based on our limited experience, we suggest that right thoracotomy with mass ligation of the right thoracic duct can successfully cure chylothorax on either side, particularly if identification of the site of leakage is considered too risky because of severe adhesion from previous cardiothoracic surgery.
回顾性分析4例心胸外科手术后乳糜胸的儿科病例，这些病例均接受了手术治疗。所有患者均接受了右胸切开术和右胸导管大块结扎术，但未检测到真正的漏出部位。尽管1例患者术后第1天死于心力衰竭，但其他3例恢复迅速，无后遗症。基于我们有限的经验，我们建议右胸切开术联合右胸导管大块结扎术可成功治愈双侧乳糜胸，特别是当由于既往心胸外科手术导致严重粘连而认为识别漏出部位风险过大时。
