Dua Sumeet, Purandare Nilendu C, Merchant Nikhil H, Pramesh C S
Department of Bioimaging, Tata Memorial Hospital, Mumbai 400012, India.
Interact Cardiovasc Thorac Surg. 2010 May;10(5):833-5. doi: 10.1510/icvts.2009.229583. Epub 2010 Feb 15.
Oesophageal resection after neoadjuvant therapy is the treatment of choice in localized oesophageal cancer. Common complications after oesophagectomy include pulmonary infection and anastomotic leaks. Paraplegia or paraparesis after oesophagectomy is an extremely uncommon occurrence and has not been reported in medical literature. Possible causes include injury to the spinal cord due to epidural catheter insertion, epidural haematoma and anterior spinal artery thrombosis. Pressure on the spinal cord due to migrated oxidised regenerated cellulose (ORC) is an extremely rare cause. Meticulous haemostasis at the costovertebral angle with a combination of pressure and electrocautery is advocated to prevent this rare but catastrophic complication. We describe a middle aged woman who developed post-thoracotomy paraplegia following ORC compression on the spinal cord.
新辅助治疗后行食管切除术是局限性食管癌的首选治疗方法。食管切除术后常见的并发症包括肺部感染和吻合口漏。食管切除术后发生截瘫或轻瘫极为罕见,医学文献中尚无相关报道。可能的原因包括硬膜外导管插入导致脊髓损伤、硬膜外血肿和脊髓前动脉血栓形成。氧化再生纤维素(ORC)移位对脊髓造成压迫是极其罕见的原因。提倡在肋椎角处进行细致的止血,结合压迫和电灼,以预防这种罕见但灾难性的并发症。我们描述了一名中年女性,她在脊髓受到ORC压迫后发生了开胸术后截瘫。