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淋巴管造影介入治疗术后乳糜胸

Lymphangiographic Interventions to Manage Postoperative Chylothorax.

作者信息

Jeong Hyuncheol, Ahn Hyo Yeong, Kwon Hoon, Kim Yeong Dae, Cho Jeong Su, Eom Jungseop

机构信息

Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University Medical Research Institution, Busan, Korea.

Department of Radiology, Pusan National University Hospital, Pusan National University Medical Research Institution, Busan, Korea.

出版信息

Korean J Thorac Cardiovasc Surg. 2019 Dec;52(6):409-415. doi: 10.5090/kjtcs.2019.52.6.409. Epub 2019 Oct 5.

Abstract

BACKGROUND

Postoperative chylothorax may be caused by iatrogenic injury of the collateral lymphatic ducts after thoracic surgery. Although traditional treatment could be considered in most cases, resolution may be slow. Radiological interventions have recently been developed to manage postoperative chylothorax. This study aimed to compare radiological interventions and conservative management in patients with postoperative chylothorax.

METHODS

We retrospectively reviewed periprocedural drainage time, length of hospital stay, and nil per os (NPO) duration in 7 patients who received radiological interventions (intervention group [IG]) and in 9 patients who received conservative management (non-intervention group [NG]).

RESULTS

The baseline characteristics of the patients in the IG and NG were comparable; however, the median drainage time and median length of hospital stay after detection of chylothorax were significantly shorter in the IG than in the NG (6 vs. 10 days, p=0.036 and 10 vs. 20 days, p=0.025, respectively). NPO duration after chylothorax detection and total drainage duration were somewhat shorter in the IG than in the NG (5 vs. 7 days and 8 vs. 14 days, respectively).

CONCLUSION

This study showed that radiological interventions reduced the duration of drainage and the length of hospital stay, allowing an earlier return to normal life. To overcome several limitations of this study, a prospective, randomized controlled trial with a larger number of patients is recommended.

摘要

背景

术后乳糜胸可能由胸外科手术后淋巴管侧支的医源性损伤引起。尽管大多数情况下可考虑传统治疗,但恢复可能较慢。放射介入治疗最近已被用于处理术后乳糜胸。本研究旨在比较放射介入治疗和保守治疗对术后乳糜胸患者的效果。

方法

我们回顾性分析了7例接受放射介入治疗的患者(介入组[IG])和9例接受保守治疗的患者(非介入组[NG])的围手术期引流时间、住院时间和禁食时间。

结果

IG组和NG组患者的基线特征具有可比性;然而,乳糜胸发现后的中位引流时间和中位住院时间,IG组显著短于NG组(分别为6天对10天,p = 0.036;10天对20天,p = 0.025)。乳糜胸发现后的禁食时间和总引流时间,IG组也略短于NG组(分别为5天对7天和8天对14天)。

结论

本研究表明,放射介入治疗缩短了引流时间和住院时间,使患者能更早恢复正常生活。为克服本研究的若干局限性,建议开展一项纳入更多患者的前瞻性随机对照试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb97/6901187/645ff7b69f0f/kjtcv-52-409f1.jpg

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