Brennan P A, Blythe J N, Herd M K, Habib A, Anand R
Maxillofacial Unit, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK.
Br J Oral Maxillofac Surg. 2012 Apr;50(3):197-201. doi: 10.1016/j.bjoms.2011.02.001. Epub 2011 Mar 4.
The considerable anatomical variation of the thin walled cervical thoracic duct predisposes it to inadvertent damage during neck dissection. If this is not recognised at the time of surgery, a chyle leak can result in potentially serious complications as well as delaying the patient's discharge from hospital. This article summarises the basic anatomy of the terminal thoracic duct in the neck and discusses the pathophysiology of a chyle leak. We present the latest ideas for managing this problem when it is identified at the time of surgery, and review the diagnosis and contemporary management options available for dealing with this difficult problem when it is found to occur post-operatively.
薄壁颈段胸导管存在显著的解剖变异，这使其在颈部解剖过程中容易受到意外损伤。如果在手术时未识别出这种情况，乳糜漏可能会导致潜在的严重并发症，并延迟患者出院。本文总结了颈部终末胸导管的基本解剖结构，并讨论了乳糜漏的病理生理学。我们提出了在手术时发现此问题的最新处理思路，并回顾了术后发现此难题时的诊断方法和当代处理选择。
