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早期非小细胞肺癌电视辅助纵隔镜淋巴结清扫术(VAMLA)后发生的术后乳糜胸。

Postoperative chylothorax following video-assisted mediastinoscopic lymphadenectomy (VAMLA) for early-stage non-small cell lung carcinoma.

作者信息

van Dam Kayleigh A M, Vissers Yvonne L J, Hulsewé Karel W E, de Loos Erik R

机构信息

Department of Surgery, Division of General Thoracic Surgery, Zuyderland Medical Center, Henri Dunantstraat 5, 6419 PC, Sittard-Geleen and Heerlen, The Netherlands.

出版信息

J Surg Case Rep. 2024 Oct 28;2024(10):rjae665. doi: 10.1093/jscr/rjae665. eCollection 2024 Oct.

Abstract

Chylothorax is a rare condition in which chylous fluid accumulates in the pleural cavity, most often due to iatrogenic injury of the thoracic duct. This paper reports a case of a woman in her 50s presenting with chyle leakage after a video-assisted mediastinoscopic lymphadenectomy (VAMLA) for staging of a nodule suspected of non-small cell lung carcinoma. After the VAMLA, a Uniportal Video Assisted Thoracoscopic Surgery lobectomy was scheduled during which the chylothorax was observed. The chyle was evacuated and the planned resection was conducted. The chest drain could be removed after 6 days while the patient followed a medium-chain triglyceride diet for 4 weeks. The purpose of this case report is to raise awareness for this very rare complication after VAMLA and discuss treatment options.

摘要

乳糜胸是一种罕见的病症,其中乳糜液积聚在胸腔内,最常见的原因是胸导管的医源性损伤。本文报告了一例50多岁女性的病例,该患者在因疑似非小细胞肺癌的结节分期而行电视辅助纵隔镜淋巴结清扫术(VAMLA)后出现乳糜漏。VAMLA术后,计划进行单孔电视辅助胸腔镜手术肺叶切除术,术中观察到乳糜胸。排出乳糜液后进行了计划中的切除手术。6天后可拔除胸腔引流管,患者同时遵循中链甘油三酯饮食4周。本病例报告的目的是提高对VAMLA后这种非常罕见并发症的认识并讨论治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c2ca/11520229/d312aacf78cb/rjae665f1.jpg

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