Qi J, Gu Z Q, Chen F, Zhang L, Chen J H
Department of Urology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China.
Singapore Med J. 2009 Sep;50(9):e338-41.
Retroperitoneal chylous effusion after urological surgery is a rare and serious complication. Failure in treatment may result in cachexia, threatening the life of the patient. We present the treatment of two cases of postoperative chyloretroperitoneum with the use of somatostatin, octreotide and total parenteral nutrition. In Case 1, an 87-year-old man, a retroperitoneal lymphatic fistula occurred four days after the resection of the left kidney due to carcinoma, whereas in Case 2, a 56-year-old man, a continuous lymph fistula from the renal fossa occurred one month after resection of the right adrenal pheochromocytoma. Case 1 was treated with intravenous administration of somatostatin, and in Case 2, treatment consisted of subcutaneous administration of octreotide, in combination with total parenteral nutrition and other symptomatic therapies. In both cases, lymph exudation was terminated in about two weeks, and the patients recovered. Somatostatin therapy and total parenteral nutrition can effectively treat chyloretroperitoneum.
泌尿外科手术后发生的腹膜后乳糜性积液是一种罕见且严重的并发症。治疗失败可能导致恶病质，危及患者生命。我们介绍了使用生长抑素、奥曲肽和全胃肠外营养治疗两例术后乳糜性腹膜后积液的病例。病例1为一名87岁男性，因肾癌行左肾切除术后4天出现腹膜后淋巴瘘；病例2为一名56岁男性，右肾上腺嗜铬细胞瘤切除术后1个月，肾窝出现持续性淋巴瘘。病例1采用静脉注射生长抑素治疗，病例2采用皮下注射奥曲肽治疗，并联合全胃肠外营养及其他对症治疗。两例患者的淋巴渗出均在约两周内停止，患者康复。生长抑素治疗和全胃肠外营养可有效治疗乳糜性腹膜后积液。
