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一种颈清扫术后高流量乳糜漏的新型处理方法:吲哚菁绿荧光引导下机器人经胸胸导管结扎术:病例系列

A Novel Method of Management of High Output Chyle Leak Following Neck Dissection: Indocyanine Green Fluorescence-guided Robotic Transthoracic Thoracic Duct Ligation: A Case Series.

作者信息

Raja Kalaiarasi, Raja Kalayarasan, Kushwaha Akshat, Ganesan Sivaraman, Penubarthi Lokesh Kumar, Paramasivam Sabharisan, Alexander Arun

机构信息

Department of Otorhinolaryngology, Jipmer, Puducherry, India.

Department of Surgical Gastroenterology, Jipmer, Puducherry, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):6041-6045. doi: 10.1007/s12070-024-05079-8. Epub 2024 Sep 24.

Abstract

High-output Chyle leak is a dreadful complication following neck dissection, posing challenges in management due to the morbidity associated with prolonged leakage. This case series describes the efficacy of a novel Indocyanine Green (ICG) Fluorescence-guided Robotic Transthoracic thoracic duct ligation technique in intractable high-output chyle leaks following neck dissection. Three patients with persistent high-output chyle leaks following neck dissection underwent robot-assisted thoracic duct ligation. Preoperative evaluation, surgical technique, postoperative care, outcomes and follow-up were recorded. All patients experienced successful resolution of chyle leaks with no intraoperative complications. Postoperative recovery was uneventful, and no recurrences were observed during the follow-up period. ICG-guided robotic transthoracic thoracic duct ligation is a safe and effective method for managing persistent high-output chyle leaks following neck dissection, offering a minimally invasive technique with favourable outcomes.

摘要

高流量乳糜漏是颈部清扫术后一种可怕的并发症,由于长期渗漏相关的发病率,给治疗带来了挑战。本病例系列描述了一种新型吲哚菁绿(ICG)荧光引导下机器人经胸胸导管结扎技术在颈部清扫术后顽固性高流量乳糜漏中的疗效。3例颈部清扫术后持续性高流量乳糜漏患者接受了机器人辅助胸导管结扎术。记录术前评估、手术技术、术后护理、结果和随访情况。所有患者乳糜漏均成功解决,术中无并发症。术后恢复顺利,随访期间未观察到复发。ICG引导下机器人经胸胸导管结扎术是治疗颈部清扫术后持续性高流量乳糜漏的一种安全有效的方法,提供了一种微创技术,效果良好。

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