Owada Yoshiyuki, Kawasaki Kentaro, Asakura Riki, Yamada Kouta, Hosono Masayoshi, Okazaki Taro, Ienaga Tetsuya
Dept. of Gastroenterological Surgery, Takatsuki General Hospital.
Gan To Kagaku Ryoho. 2018 Dec;45(13):1866-1868.
A man in his sixties with a medical history of diabetes and dyslipidemia was detected with a tumor with massive submucosal invasion on colonoscopy. He was diagnosed with sigmoid cancer and underwent laparoscopic sigmoid colectomy with D3 lymph node dissection. An electric surgical knife and an ultrasonically activated device was used to perform D3 lymph node dissection with preservation of the left colic artery(LCA)and division of the S1A and S2A. On postoperative day 4(POD4), 1 day after oral intake was started, chylous ascites began to develop. Owing to the small volume of ascites, oral feeding was continued, and chylous ascites was treated successfully with a low-fat diet. Chylous ascites immediately reduced on POD6, after which the drain was removed on POD7. He was discharged on POD9. Fasting and complete parenteral nutrition are not necessarily required in the treatment of chyle leakage after laparoscopic colorectal cancer surgery.
一名患有糖尿病和血脂异常病史的60多岁男性在结肠镜检查时发现一个伴有大量黏膜下浸润的肿瘤。他被诊断为乙状结肠癌，并接受了腹腔镜乙状结肠切除术及D3淋巴结清扫术。使用电外科刀和超声激活设备进行D3淋巴结清扫，保留左结肠动脉（LCA）并切断S1A和S2A。术后第4天（POD4），开始经口进食1天后，乳糜腹水开始出现。由于腹水量少，继续经口喂养，低脂饮食成功治疗了乳糜腹水。乳糜腹水在POD6时立即减少，之后在POD7时拔除引流管。他于POD9出院。腹腔镜结直肠癌手术后乳糜漏的治疗不一定需要禁食和完全肠外营养。
