Leray Hélène, Brouchet Laurent, Tanguy Le Gac Yann, Bouharaoua Sihem, Otal Philippe, Ferron Gwenaël, Gabiache Erwan, Angeles Martina Aida, Martínez-Gómez Carlos, Martinez Alejandra
Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse (IUCT) - Oncopole, Toulouse, France.
Department of Thoracic Surgery, Hospital Larrey, Toulouse University Hospital, Toulouse, France.
Gynecol Oncol Rep. 2021 Feb 13;36:100727. doi: 10.1016/j.gore.2021.100727. eCollection 2021 May.
Resection of enlarged cardiophrenic lymph nodes (CPLN) is a procedure required to obtain complete cytoreduction in selected patients affected by advanced ovarian cancer. Their resection by transdiaphragmatic approach has been demonstrated to be feasible with low rates of morbidity. The main complications associated with this procedure are pleural effusion, pneumothorax, and rarely, chylothorax. This case describes a postoperative chylothorax and chest liver herniation in a patient who underwent a cytoreductive surgery for advanced endometrioid ovarian cancer, which included a right transdiaphragmatic CPLN resection. Surgical management by thoracotomy was required to repair the right diaphragmatic defect combined with conservative management of the chylothorax. The diaphragmatic closure was achieved employing interrupted stitches with a non-absorbable suture. No prosthetic material was required.
切除增大的心膈淋巴结（CPLN）是在部分晚期卵巢癌患者中实现完全细胞减灭所需的一种手术。经膈入路切除这些淋巴结已被证明是可行的，且发病率较低。与该手术相关的主要并发症是胸腔积液、气胸，很少见的是乳糜胸。本病例描述了一名接受晚期子宫内膜样卵巢癌细胞减灭术（包括经膈右侧CPLN切除术）的患者术后发生乳糜胸和胸腔肝疝。需要通过开胸手术进行外科处理，以修复右侧膈肌缺损并结合乳糜胸的保守治疗。采用不可吸收缝线间断缝合实现了膈肌闭合。无需使用假体材料。
