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内淋巴囊封闭术治疗神经母细胞瘤切除术后小儿乳糜性腹水:2例报告

Endolymphatic exclusion for the treatment of pediatric chylous ascites secondary to neuroblastoma resection: report of two cases.

作者信息

Woerner Andrew, Shin David S, Chick Jeffrey Forris Beecham, Smith Caitlin A, Sarthy Jay F, Monroe Eric J

机构信息

Interventional Radiology Section, Department of Radiology, University of Washington, 1959 Northeast Pacific Street, Seattle, WA 98195, USA.

Division of Vascular and Interventional Radiology, Department of Radiology, Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA.

出版信息

Radiol Case Rep. 2020 May 19;15(7):1044-1049. doi: 10.1016/j.radcr.2020.04.060. eCollection 2020 Jul.

Abstract

Chylous ascites is a rare, but highly morbid complication of oncologic resection, often associated with retroperitoneal lymphadenectomy. Conservative measures with total parenteral nutrition or lipid-reduced formulas constitute the initial mainstay therapy, but not without risks and failures. This report describes 2 endolymphatic treatment strategies for iatrogenic chylous ascites following neuroblastoma resection. Lymphatic leaks were identified using intranodal lymphangiography, targeted with cone-beam computed tomographic guidance, and embolized with n-butyl cyanoacrylate. There were no adverse outcomes, with complete resolution of chylous ascites and a mean follow-up of 26 months.

摘要

乳糜性腹水是肿瘤切除术后一种罕见但严重的并发症,常与腹膜后淋巴结清扫术相关。全胃肠外营养或低脂配方的保守措施是初始的主要治疗方法,但并非没有风险和失败案例。本报告描述了神经母细胞瘤切除术后医源性乳糜性腹水的两种淋巴管内治疗策略。通过节点内淋巴管造影识别淋巴漏,在锥形束计算机断层扫描引导下进行靶向治疗,并使用氰基丙烯酸正丁酯进行栓塞。没有出现不良后果,乳糜性腹水完全消退,平均随访26个月。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe80/7240057/8f8f083662b1/gr1.jpg

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