Department of Plastic Surgery, Addenbrookes Hospital, Cambridge, UK.
J Plast Reconstr Aesthet Surg. 2011 Sep;64(9):e223-30. doi: 10.1016/j.bjps.2010.12.018. Epub 2011 Feb 5.
Chyle leakage post head-and-neck resection is a rare but potentially life-threatening complication. Management may be problematic and prolonged. Recently, thoracoscopic ligation of the thoracic duct has emerged as a promising technique to definitively treat this difficult problem. We present a recent case of a hemimandibulectomy, radical modified neck dissection and osseocutaneous fibular-free-flap complicated by a chyle leakage. The chyle leak was successfully treated with thoracoscopic ligation of the thoracic duct. In the light of our clinical experience and following a thorough literature review, we have proposed that complicated or high-output chyle leaks (>1000 ml day(-1)) should be treated with early thoracoscopic thoracic duct ligation.
颈头部切除术后乳糜漏是一种罕见但潜在威胁生命的并发症。处理可能会很棘手，且需要很长时间。最近，胸腔镜胸导管结扎术已成为治疗这一难题的一种有前途的技术。我们最近报告了一例半下颌骨切除术、根治性改良颈淋巴结清扫术和骨皮瓣游离腓骨瓣术后并发乳糜漏的病例。乳糜漏通过胸腔镜胸导管结扎成功治疗。根据我们的临床经验和彻底的文献复习，我们提出对于复杂或高输出乳糜漏（>1000 ml/天），应早期进行胸腔镜胸导管结扎。
