Thoracic Surgical Services, RWJ Barnabas Health, West Orange, New Jersey.
Thoracic Surgical Services, RWJ Barnabas Health, West Orange, New Jersey.
Ann Thorac Surg. 2020 Jun;109(6):e401-e402. doi: 10.1016/j.athoracsur.2019.09.090. Epub 2019 Nov 22.
Chyle leaks after esophagectomy are associated with significant morbidity and mortality. High-output fistulas are particularly difficult to manage, as the likelihood of spontaneous closure with conservative management is low. Leaks that fail to resolve with conservative management are referred for thoracic duct ligation or embolization. Some patients, however, are not candidates for these procedures or have persistent output despite intervention. We report a case of a post-McKeown esophagectomy patient with a high-output chyle leak despite intraoperative thoracic duct ligation. Treatment was successful with a modified blood patch through a neck drain.
胸导管结扎或栓塞。然而，有些患者不适合这些手术，或尽管进行了干预，但仍有持续性渗液。我们报告了一例 McKeown 食管切除术患者，尽管术中进行了胸导管结扎，但仍出现高流量乳糜漏。通过颈部引流管进行改良的血液填塞治疗取得了成功。
