Har-El G, Segal K, Sidi J
Head Neck Surg. 1985 Jan-Feb;7(3):225-30. doi: 10.1002/hed.2890070307.
Bilateral chylothorax as a complication of radical neck dissection is extremely rare. Six cases are reported in the English literature. All of these patients' cases were associated with a concurrent external chylous fistula, as evidenced by the appearance of a milky fluid confirmed to be chyle by chemical determination. Chyle had also been noted to leak during the operation. This presentation illustrates an additional case of bilateral chylothorax occurring after radical neck dissection, and the first case, to our knowledge, with no concurrent external lymph leakage. Anatomic and physiologic considerations are presented and possible mechanisms of pathogenesis are discussed. Chylothorax has two major complications--respiratory and metabolic. A short summary of the modern concepts of treatment is presented.
双侧乳糜胸作为根治性颈清扫术的并发症极为罕见。英文文献中报道了6例。所有这些患者的病例均伴有同时存在的外部乳糜瘘，化学测定证实为乳糜的乳白色液体外观可证明这一点。术中也注意到有乳糜渗漏。本病例介绍了1例根治性颈清扫术后发生双侧乳糜胸的病例，据我们所知，这是第1例无同时存在外部淋巴渗漏的病例。文中阐述了解剖学和生理学方面的考虑因素，并讨论了可能的发病机制。乳糜胸有两个主要并发症——呼吸和代谢方面的。文中简要总结了现代治疗理念。
