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淋巴管造影及胸导管栓塞术治疗隆乳术和乳房固定术后持续性乳糜漏

Lymphangiography and thoracic duct embolization for persistent chyle leak following augmentation mammoplasty and mastopexy.

作者信息

Issagholian Leo, Malkoc Aldin, Vignaroli Kendall A, Miramontes Melissa, Neeki Cameron C, Nguyen Anthony, Neeki Michael M

机构信息

Arrowhead Regional Medical Center, Department of Emergency Medicine, 400N Pepper Ave Colton, CA 92324, USA.

California University of Science and Medicine, Colton, CA 92324, USA.

出版信息

JPRAS Open. 2024 Sep 10;42:191-196. doi: 10.1016/j.jpra.2024.09.005. eCollection 2024 Dec.

Abstract

Chyle leak is a relatively rare post-operative complication of breast and axilla surgery, and the majority of these cases can be managed conservatively. We present the case of a 42-year-old female with chyle leak within the external thoracic cavity following elective augmentation mammoplasty and mastopexy. This patient failed initial operative management consisting of implant removal, washout, suture plication, and intra-operative drain placement as well as subsequent conservative management including diet modification, total parenteral nutrition, and percutaneous aspiration. Ultimately, this patient's chyle leak was successfully managed with lymphangiography and thoracic duct embolization. To our knowledge, this is the first documented case of successful use of lymphangiography with embolization to manage chyle leak within the superficial chest, and this intervention should be considered when contemplating management of this post-operative complication within the breast cavity.

摘要

乳糜漏是乳房和腋窝手术后相对罕见的一种并发症,大多数此类病例可采用保守治疗。我们报告了一例42岁女性患者,在择期隆乳术和乳房固定术后出现胸腔外乳糜漏。该患者最初的手术治疗包括取出植入物、冲洗、缝合折叠以及术中放置引流管,但均未成功,随后的保守治疗,包括饮食调整、全胃肠外营养和经皮抽吸也未成功。最终,该患者的乳糜漏通过淋巴管造影和胸导管栓塞术得到成功治疗。据我们所知,这是首例成功使用淋巴管造影和栓塞术治疗浅表胸部乳糜漏的记录病例,在考虑处理乳房腔内这种术后并发症时应考虑这种干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb41/11472013/e859fff56cf5/gr1.jpg

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