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术后乳糜胸伴左侧胸导管重复畸形:病例报告及文献复习。

Postoperative chylothorax with a duplicated left-sided thoracic duct: a case report and review of the literature.

机构信息

Division of Esophageal Surgery, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.

Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan.

出版信息

Gen Thorac Cardiovasc Surg. 2020 Nov;68(11):1350-1353. doi: 10.1007/s11748-020-01374-7. Epub 2020 May 8.

Abstract

Postoperative chylothorax is a potentially lethal complication after esophagectomy. A 53-year-old woman underwent subtotal esophagectomy. The thoracic duct was resected due to swollen lymph nodes. Postoperative chylothorax was diagnosed but conservative treatment was ineffective. Lipiodol lymphangiography revealed leakage from a duplicated left-sided thoracic duct. Left-sided video-assisted thoracoscopic ligation of the left-sided thoracic duct was performed. Because anatomical variations in the thoracic duct contribute to refractory chylothorax, lymphangiography is useful in detecting the position of thoracic duct injury as well as any duct anomalies. Based on lymphangiography, left-sided video-assisted thoracoscopic surgery could be considered in case of left-sided thoracic duct injury.

摘要

术后乳糜胸是食管癌手术后一种潜在的致命并发症。一名 53 岁女性接受了食管次全切除术。由于淋巴结肿大,胸导管被切除。术后诊断为乳糜胸,但保守治疗无效。碘化油淋巴造影显示左侧胸导管漏出。行左侧胸腔镜辅助下左侧胸导管结扎术。由于胸导管的解剖变异导致难治性乳糜胸,淋巴造影术有助于检测胸导管损伤的位置和任何导管异常。基于淋巴造影,如果发生左侧胸导管损伤,可考虑行左侧胸腔镜辅助手术。

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