Department of Surgical Oncology, Shantou Central Hospital, Shantou, China.
Department of Medical Oncology, Shantou Central Hospital, Shantou, China.
Ann Thorac Surg. 2019 May;107(5):1540-1543. doi: 10.1016/j.athoracsur.2018.10.053. Epub 2018 Nov 30.
Chylothorax after esophagectomy is uncommon but potentially fatal. We performed a retrospective study to assess the effect of olive oil administered orally before surgery on reducing chylothorax in patients who underwent minimal invasive esophagectomy.
Between May 2013 and December 2016, patients with esophageal squamous cell cancer who underwent minimal invasive esophagectomy were screened. Patients in the investigational group were preoperatively administered olive oil orally 8 hours before surgery, and patients in the control arm received no olive oil. We used a propensity score matching model to derive 1:1 cohorts. Statistical analysis was performed by using the t test or χ or Fisher's exact test.
The propensity score matching model finally selected 384 of 425 patients, with 192 patients in each group. The patient characteristics were balanced. Oral olive oil was well tolerated. The thoracic duct identification rate was higher in the investigational group (100% versus 45.31%, χ = 141.78, p < 0.01). The investigational group was associated with a reduced incidence of ligation (7.81% versus 18.22%, χ = 8.03, p = 0.003). The incidence of chylothorax was significantly reduced in the investigational group compared with that of the control group (0% versus 3.12%, χ = 4.23, p = 0.03).
Preoperative administration of olive oil is a simple and safe method to minimize chylothorax complicating minimal invasive esophagectomy.
食管癌手术后乳糜胸并不常见，但可能致命。我们进行了一项回顾性研究，评估手术前口服橄榄油对微创食管癌患者减少乳糜胸的效果。
2013 年 5 月至 2016 年 12 月，筛选接受微创食管癌切除术的食管鳞状细胞癌患者。实验组患者术前 8 小时口服橄榄油，对照组患者未给予橄榄油。我们使用倾向评分匹配模型得出 1:1 的队列。使用 t 检验或 χ 或 Fisher 确切检验进行统计分析。
倾向评分匹配模型最终选择了 425 例患者中的 384 例，每组 192 例。患者特征平衡。口服橄榄油耐受性良好。实验组胸导管识别率较高（100%比 45.31%，χ=141.78，p<0.01）。实验组与结扎发生率降低相关（7.81%比 18.22%，χ=8.03，p=0.003）。实验组乳糜胸发生率明显低于对照组（0%比 3.12%，χ=4.23，p=0.03）。
术前给予橄榄油是一种简单、安全的方法，可以最大限度地减少微创食管癌术后并发乳糜胸。
