Nakamura Kohei, Nakayama Kentaro, Minamoto Toshiko, Ishibashi Tomoka, Ohnishi Kaori, Yamashita Hitomi, Ono Ruriko, Sasamori Hiroki, Razia Sultana, Kamrunnahar Shanta, Ishikawa Masako, Kyo Satoru
Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane 693-8501, Japan.
Mol Clin Oncol. 2018 Aug;9(2):178-180. doi: 10.3892/mco.2018.1647. Epub 2018 Jun 8.
Although lymphadenectomy for gynecological cancer is often associated with chylous leakage, the proper management of this complication remains a matter of debate. In the present study a case of chylous leakage successfully treated with lipiodol lymphangiography is described. A 33-year-old patient with ovarian cancer experienced chylous leakage following total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic and para-aortic lymphadenectomy. The volume of fluid in the abdominal drainage tube increased to 800-1,000 ml/day on postoperative day (POD)3. The patient was started on a fat-restricted diet on POD3 and octreotide on POD21, but the volume of the discharge remained unchanged. Lipiodol lymphangiography was performed on POD62, which reduced the leakage, and the patient was discharged on POD95. Therefore, lipiodol lymphangiography effectively resolved chylous leakage following surgery for gynecological cancer. The aim of the present study was to report the clinical effectiveness of lipiodol lymphangiography in resolving chylous leakage in such cases, and to summarize the methods used and complications encountered.
尽管妇科癌症的淋巴结清扫术常伴有乳糜漏，但对该并发症的恰当处理仍存在争议。本研究描述了一例经碘油淋巴管造影成功治疗乳糜漏的病例。一名33岁的卵巢癌患者在全腹子宫切除术、双侧输卵管卵巢切除术、大网膜切除术以及盆腔和腹主动脉旁淋巴结清扫术后出现乳糜漏。术后第3天，腹腔引流管中的液体量增加至每天800 - 1000毫升。患者在术后第3天开始接受低脂饮食，并于术后第21天开始使用奥曲肽，但引流量仍未改变。在术后第62天行碘油淋巴管造影，乳糜漏减少，患者于术后第95天出院。因此，碘油淋巴管造影有效地解决了妇科癌症手术后的乳糜漏问题。本研究的目的是报告碘油淋巴管造影在解决此类病例中乳糜漏的临床有效性，并总结所采用的方法及遇到的并发症。
