Department of Neurosurgery, Swedish Neuroscience Institute, Seattle, Washington 98122, USA.
J Neurosurg Spine. 2012 Nov;17(5):415-21. doi: 10.3171/2012.8.SPINE12243. Epub 2012 Sep 14.
Injury to the lymphatic channels is a rare and relatively unknown complication of anterior approaches to the lumbar spine and can cause fluid to build up in the retroperitoneal space, resulting in a lymphocele. If they enlarge sufficiently, these collections of chyle in the abdomen can cause pain and bowel ischemia, and can compress nearby organs. The authors report 4 cases in which anterior approaches to the lumbar spine were complicated by a postoperative retroperitoneal chylous fluid collection. They describe the anatomy of the lymphatic system and pathophysiology of this disease entity, review the sparse literature on this subject, and recommend a treatment algorithm. Maintaining a high index of suspicion for this clinical entity in patients who have recently undergone an anterior approach to the thoracic or lumbar spine is vital to avoid delays in diagnosis and treatment.
淋巴管损伤是腰椎前路手术中一种罕见且相对未知的并发症，可导致腹膜后腔积液，形成淋巴囊肿。如果这些积聚物足够大，腹部的乳糜液会引起疼痛和肠缺血，并压迫附近的器官。作者报告了 4 例腰椎前路手术后出现腹膜后乳糜液积聚的病例。他们描述了淋巴系统的解剖结构和该疾病实体的病理生理学，回顾了关于该主题的稀少文献，并推荐了一种治疗算法。对于最近接受过胸腰椎前路手术的患者，对这种临床实体保持高度怀疑至关重要，以避免诊断和治疗的延误。
