Kamiyoshihara Mitsuhiro, Kakegawa S, Kawashima O, Otani Y, Morishita Y
Department of General Thoracic Surgery, Maebashi Red Cross Hospital, Maebashi, Japan.
Kyobu Geka. 2005 Dec;58(13):1189-91.
Thoracoscopic clipping of the thoracic duct was successfully performed for the treatment of postoperative chylothorax. Chylothorax occurred in a 67-year-old man following an esophagectomy for esophageal cancer. Following unsuccessful conservative therapy for 3 weeks, we performed thoracoscopic surgery to examine the thoracic duct and found a leaking point of chylous fluid. The thoracic duct was successfully clipped resulting in complete elimination of the effusion immediately after surgery. Generally, chylothorax complicated by an esophagectomy has been managed by medical treatment first, followed by surgical intervention in case of uncontrollable pleural effusion. We think you should try this method at first in case chylothorax was able to be treated with not thoracotomy but thoracoscopic surgery: minimal invasiveness.
胸腔镜下胸导管夹闭术成功用于治疗术后乳糜胸。一名67岁男性在食管癌切除术后发生乳糜胸。经过3周的保守治疗失败后,我们进行了胸腔镜手术以检查胸导管,并发现了乳糜液漏出点。胸导管成功夹闭,术后立即完全消除了积液。一般来说,食管癌切除术后并发的乳糜胸首先采用内科治疗,若胸腔积液无法控制则进行手术干预。我们认为,万一乳糜胸能够通过胸腔镜手术而非开胸手术进行治疗,即微创性治疗,应首先尝试这种方法。