Department of Lymphatic Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Ann Palliat Med. 2021 Apr;10(4):4768-4776. doi: 10.21037/apm-21-263. Epub 2021 Apr 16.
Chylothorax is caused by accumulation of chylous fluid in the thoracic cavity following injury to the thoracic duct or its tributaries. It is a rare but relatively severe complication of lung cancer surgery, especially after lung resection and mediastinal lymph node dissection. If chylothorax is not treated promptly and effectively, it may result in relatively high mortality rate. Although the majority of patients with chylothorax secondary to lung cancer surgery can be treated with conservative measures, there are still some patients who fail to respond to conservative treatment or suffer from recurrent episodes. This study aims to explore the causes of postoperative chylothorax and how targeted treatment can help achieve better outcomes.
Four cases of chylothorax secondary to lung cancer surgery are reported in which patients underwent direct lymphangiography (DLG) after failed conservative treatment.
Thoracic duct obstruction was found in all patients on DLG, as well as dilated intrathoracic part of the thoracic duct. Thoracic duct reconstruction was performed to successfully treat 3 of the 4 patients.
DLG is of great value in the diagnosis of chylothorax secondary to lung cancer surgery, for which thoracic duct reconstruction proves to be an effective procedure. DLG provides a new objective basis for the diagnosis and treatment of chylothorax. It is our best wish to help more patients with chylothorax secondary to lung cancer surgery.
乳糜胸是由于胸导管或其分支损伤后，乳糜液在胸腔内积聚而引起的。它是肺癌手术后一种罕见但相对严重的并发症，尤其是在肺切除和纵隔淋巴结清扫术后。如果乳糜胸不能及时有效地治疗，可能会导致相对较高的死亡率。虽然大多数肺癌手术后并发乳糜胸的患者可以通过保守治疗得到治疗，但仍有一些患者对保守治疗反应不佳或反复发作。本研究旨在探讨肺癌手术后乳糜胸的原因以及如何进行靶向治疗以获得更好的结果。
报告了 4 例肺癌手术后并发乳糜胸的病例，这些患者在保守治疗失败后进行了直接淋巴管造影（DLG）。
所有患者在 DLG 上均发现胸导管阻塞，以及胸导管胸腔内部分扩张。对 4 例患者中的 3 例进行了胸导管重建，治疗成功。
DLG 对肺癌手术后乳糜胸的诊断具有重要价值，胸导管重建是一种有效的治疗方法。DLG 为乳糜胸的诊断和治疗提供了新的客观依据。我们衷心希望能够帮助更多的肺癌手术后并发乳糜胸的患者。
