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甲状腺癌行全甲状腺切除及颈部淋巴结清扫术后双侧乳糜胸:1例病例报告及文献复习

Bilateral chylothorax following total thyroidectomy with neck lymph node dissection for thyroid cancer: a case report and literature review.

作者信息

Wang Yunsheng, Liu Xudong, Wang Xingyue, Tian Youxin, Liu Qinjiang, Wang Jun, Xue Jincai

机构信息

Department of Head and Neck Surgery, Gansu Provincial Cancer Hospital, Lanzhou, China.

出版信息

Front Oncol. 2025 Jan 8;14:1489410. doi: 10.3389/fonc.2024.1489410. eCollection 2024.

Abstract

PURPOSE

Investigating the diagnosis and treatment of bilateral Chylothorax after neck lymph node dissection for thyroid cancer.

METHODS

The clinical data of a patient with bilateral chylothorax after neck lymph node dissection for thyroid cancer were retrospectively analyzed, and the relevant literature was reviewed.

RESULTS

The patient underwent a total thyroidectomy and left neck lymph node dissection, with no evidence of lymph fluid leakage observed during the operation. The patient experienced chest tightness, shortness of breath, dyspnea, and decreased lung auscultation breath sounds on the 7th day after the surgery. The chest X-ray examination revealed the presence of bilateral pleural effusion. Under ultrasound guidance, bilateral thoracic closed drainage tube was implanted, and a small sample of the milky white fluid was tested for chylothorax, yielded positive results. The patient is diagnosed with bilateral chylothorax. After received conservative treatment, the patient's drainage flow gradually decreased. Subsequent review of a chest X-ray showed no signs of chest hydrops, and as a result, the thoracic drainage tube was removed. The patient eventually recovered and was subsequently discharged.

CONCLUSION

Bilateral chylothorax is a rare complication following neck lymph node dissection for thyroid cancer. It is deemed safe and effective to administer active conservative treatment upon early detection.

摘要

目的

探讨甲状腺癌颈淋巴结清扫术后双侧乳糜胸的诊断与治疗。

方法

回顾性分析1例甲状腺癌颈淋巴结清扫术后发生双侧乳糜胸患者的临床资料,并复习相关文献。

结果

患者行甲状腺全切及左侧颈淋巴结清扫术,术中未见淋巴液漏出。术后第7天患者出现胸闷、气短、呼吸困难,肺部听诊呼吸音减弱。胸部X线检查示双侧胸腔积液。在超声引导下,双侧胸腔置入闭式引流管,抽取少量乳白色液体检测,结果提示乳糜胸阳性。患者被诊断为双侧乳糜胸。经保守治疗后,患者引流量逐渐减少。随后复查胸部X线未见胸腔积液征象,拔除胸腔引流管。患者最终康复并出院。

结论

双侧乳糜胸是甲状腺癌颈淋巴结清扫术后罕见的并发症。早期发现后积极保守治疗安全有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/484b/11751029/0d810a3cd554/fonc-14-1489410-g001.jpg

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