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[乳糜胸。食管手术切除中一种罕见的并发症]

[Chylothorax. An infrequent complication in surgical exeresis of the esophagus].

作者信息

Faulí A, Suárez M, Castro M J, García-Huete L, Udina E, Vilaplana J

机构信息

Servicio de Anestesiología, reanimación y Terapéutica del Dolor Ciudad Sanitaria de Bellvitge-Prínceps d'Espanya, L'Hospitalet de Llobregat, Barcelona.

出版信息

Rev Esp Anestesiol Reanim. 1992 Jan-Feb;39(1):43-5.

PMID:1598452
Abstract

We report a case of massive bilateral chylothorax occurring after surgical resection of the esophagus in a patient with esophageal neoplasm. The surgical approach consisted of a thoracotomy and a cervicostomy. The relevance of this case is based on the low incidence of chylothorax after esophageal surgery. The literature indicates an incidence of about 0.9 to 3%. In our series of 200 patients operated on during the last 10 years we found and incidence of 2%. The patient herein reported presented an immediate postoperative clinical picture of respiratory insufficiency associated with the presence of milky fluid in the pleural drainage. Hematologic and biochemical examination of the pleural fluid confirmed the diagnosis of chylothorax. During the first 24 hours we collected a total volume of 2,500 ml of chyle. The patient was treated with conservative procedures including parenteral nutrition and intravenous reposition of fluids. After 48 hours the total volume of chyle reached 8,500 ml and the patient died.

摘要

我们报告了一例食管肿瘤患者在食管手术切除后发生大量双侧乳糜胸的病例。手术方式包括开胸手术和颈部造口术。该病例的相关性基于食管手术后乳糜胸的低发病率。文献表明发病率约为0.9%至3%。在我们过去10年中手术治疗的200例患者系列中,我们发现发病率为2%。本文报告的患者术后立即出现呼吸功能不全的临床表现,并伴有胸腔引流液中出现乳状液体。胸腔积液的血液学和生化检查证实了乳糜胸的诊断。在最初的24小时内,我们共收集了2500毫升乳糜。患者接受了包括肠外营养和静脉补液在内的保守治疗。48小时后,乳糜总量达到8500毫升,患者死亡。

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