Yang Young Ho, Park Seong Yong, Kim Dae Joon
Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Korea.
Korean J Thorac Cardiovasc Surg. 2020 Aug 5;53(4):191-199. doi: 10.5090/kjtcs.2020.53.4.191.
Surgeons recommend dissecting lymph nodes in the thorax, abdomen, and neck during surgery for esophageal cancer because of the possibility of metastasis to the lymph nodes in those areas through the lymphatic plexus of the esophageal submucosal layer. Extensive lymph node dissection is essential for accurate staging and is thought to improve survival. However, it can result in several complications, including chyle leakage, which refers to continuous lymphatic fluid leakage and can occur in the thorax, abdomen, and neck. Malnutrition, fluid imbalance, and immune compromise may result from chyle leakage, which can be potentially life-threatening if it persists. Therefore, various treatment methods, including conservative treatment, pharmacological treatment such as octreotide infusion, and interventions such as thoracic duct embolization and surgical thoracic duct ligation, have been applied. In this article, the risk factors, diagnosis, and treatment methods of chyle leakage after esophagectomy are reviewed.
由于食管癌有可能通过食管黏膜下层的淋巴丛转移至胸部、腹部和颈部的淋巴结，外科医生建议在食管癌手术期间对这些部位的淋巴结进行清扫。广泛的淋巴结清扫对于准确分期至关重要，并且被认为可以提高生存率。然而，它可能导致多种并发症，包括乳糜漏，即淋巴液持续漏出，可发生于胸部、腹部和颈部。乳糜漏可能导致营养不良、液体失衡和免疫功能受损，如果持续存在，可能会危及生命。因此，已经应用了各种治疗方法，包括保守治疗、诸如注射奥曲肽的药物治疗以及诸如胸导管栓塞和胸导管手术结扎等干预措施。在本文中，对食管切除术后乳糜漏的危险因素、诊断和治疗方法进行了综述。
