Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
J Minim Invasive Gynecol. 2018 Jul-Aug;25(5):923-926. doi: 10.1016/j.jmig.2017.12.028. Epub 2018 Feb 7.
A 23-year-old female patient with refractory chylous ascites was successfully treated with laparoscopic ligation of the ruptured lymphatic vessel. The young patient developed abdominal distention after right-side pelvic lymph node dissection for dysgerminoma of the right ovary. Conservative managements failed to control the symptoms. Laparoscopic surgery was performed after oral administration of peanut oil, revealing the presence of a whitish fluid in the abdominal cavity. The responsible lesion of the chylous ascites was detected in the right obturator fossa and ligated with the HEM-O-LOK System (Kangji Medical Instrument Co., Ltd., Hangzhou City, Zhejiang Province, China). The patient experienced an uneventful recovery and has been completely free of symptoms for 1 year. Laparoscopic surgery should be considered as a treatment of choice for intractable chylous ascites, and peanut oil could be used before surgery as an effective way to facilitate detection of the leakage during surgery.
一位 23 岁的女性患者因难治性乳糜性腹水成功接受腹腔镜破裂淋巴管结扎术治疗。该年轻患者因右侧卵巢无性细胞瘤行右侧盆腔淋巴结清扫术后出现腹胀，保守治疗未能控制症状。在口服花生油后行腹腔镜检查，发现腹腔内有乳白色液体。在右闭孔窝发现乳糜性腹水的责任病灶，并使用 HEM-O-LOK 系统（浙江康基医疗器械有限公司）结扎。患者恢复顺利，无并发症，随访 1 年无复发。腹腔镜手术应作为治疗难治性乳糜性腹水的首选方法，术前可使用花生油作为有效方法，便于术中发现漏液。
