Department of Orthopaedic Surgery, University of Miami, Miami, Florida.
Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.
JBJS Case Connect. 2020 Jan-Mar;10(1):e0100. doi: 10.2106/JBJS.CC.19.00100.
We report the first documented case of chylous leak recognized intraoperatively during posterior spinal instrumentation and fusion for juvenile scoliosis in a female patient with a history of thoracotomy and decortication for an empyema.
Thoracic duct injury can lead to severe morbidity and mortality because of chylothorax formation. Although chylous leaks are a well-documented complication of the anterior approach to spine surgery, leaks during the posterior approach are rarely reported. When these chylous leaks are recognized intraoperatively, the likelihood of serious complications may be minimized by drain placement before closure.
我们报告了首例术中发现的乳糜漏病例,该病例为女性青少年脊柱侧凸后路脊柱内固定融合术,该患者既往因脓胸行剖胸术和肋骨切除术。
胸导管损伤可导致严重的发病率和死亡率,因为乳糜胸的形成。尽管乳糜漏是脊柱手术前路的一个有充分文献记载的并发症,但后路手术中的漏液很少有报道。当这些乳糜漏在术中被发现时,通过在关闭前放置引流管,可能会最大限度地减少严重并发症的发生。