Wang T Y
Beijing Friendship Hospital.
Zhonghua Wai Ke Za Zhi. 1990 Apr;28(4):218-9, 252-3.
8 patients with postoperative chylothorax were reported: 7 after resection of esophageal carcinoma, 1 after radical correction of tetralogy of Fallot. 1 case was treated conservatively and 7 by ligation of thoracic duct after rethoracotomy. All the cases recovered. The factors causing postoperative chylothorax, the principles of treatment, and the role of prophylactic ligation of thoracic duct were discussed. The authors point out that, the mechanisms of postoperative chylothorax after open heart surgery by sternotomy may be: (1) injury of perithymotic and anterior mediastinal lymph ducts; (2) injury of thoracic duct through posterior wall of pericardium; and (3) effect of hypertension of systemic veins on flow of thoracic duct.
报告了8例术后乳糜胸患者:7例为食管癌切除术后,1例为法洛四联症根治术后。1例采用保守治疗,7例经开胸术后结扎胸导管。所有病例均康复。讨论了术后乳糜胸的成因、治疗原则以及预防性结扎胸导管的作用。作者指出,胸骨切开开心脏手术后发生术后乳糜胸的机制可能为:(1)胸腺周围及前纵隔淋巴管损伤;(2)经心包后壁损伤胸导管;(3)体循环静脉高压对胸导管血流的影响。