Faculty of Medicine, Department of Anatomy-Histology-Embryology, School of Health Sciences, University of Ioannina, Greece.
Faculty of Medicine, Department of Anatomy, School of Health Sciences, National and Kapodistrian University of Athens, Greece.
Vasa. 2024 Nov;53(6):371-377. doi: 10.1024/0301-1526/a001146. Epub 2024 Aug 29.
The anatomical variability of the thoracic duct and the right lymphatic duct predisposes them to inadvertent damage following head and neck surgery thereby leading to chyle leak which is an uncommon complication with potentially significant associated morbidity. Although chyle leak is predominately associated with left-sided neck surgery, it also occurs as a complication of the right-sided neck dissection. Variable figures concerning chyle leakage after right-sided neck dissections were reported, ranging from 0 per cent to higher prevalences such as 14%, 24%, 33% and 60% of total cases of chyle leakages associated with neck surgery. The right-sided complications may implicate the right lymphatic duct and right-sided terminations of the thoracic duct into the venous system which occur in about 1-6% of humans. Other clinically relevant conditions involving the right-sided major lymphatic vessels include chyle leaks following right anterior cervical spine surgery, cysts of the right lymphatic duct and dilatation of the right lymphatic duct in the setting of recurrent cervical swelling. This article presents a review of the literature concerning the basic anatomy and the clinical relevance of the right lymphatic duct and the right-sided terminations of the thoracic duct into the venous circulation.
胸导管和右淋巴导管的解剖变异性使它们在头颈部手术后容易受到无意中的损伤，从而导致乳糜漏，这是一种罕见的并发症，可能会导致严重的相关发病率。尽管乳糜漏主要与左侧颈部手术有关，但它也可能是右侧颈部清扫术的并发症。关于右侧颈部手术后乳糜漏的发生率有不同的报道，从 0%到更高的发生率，如与颈部手术相关的乳糜漏总病例的 14%、24%、33%和 60%。右侧并发症可能涉及右侧淋巴导管和胸导管在静脉系统中的右侧末端，这种情况在大约 1-6%的人中发生。涉及右侧主要淋巴血管的其他临床相关情况包括右侧前颈脊柱手术后的乳糜漏、右淋巴导管囊肿和复发性颈部肿胀时右淋巴导管扩张。本文综述了有关右淋巴导管和胸导管在静脉循环中的右侧末端的基本解剖结构和临床相关性的文献。
