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一例因部分腹腔镜肾切除术后导致严重腹膜后乳糜漏及继发乳糜胸的病例。

A case of severe retroperitoneal chyle leakage and subsequent chylothorax secondary to partial laparoscopic nephrectomy.

作者信息

Ping Lu, Wang Chuhan, Huang Haoran, Cui Runmeng, Cao Jian, Dong Jie

机构信息

Department of General Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

出版信息

Urol Case Rep. 2025 Apr 9;60:103037. doi: 10.1016/j.eucr.2025.103037. eCollection 2025 May.

Abstract

Retroperitoneal chyle leakage combined with chylothorax after nephrectomy is rare in clinical practice. We report a 41-year-old female who developed severe chyloretroperitoneum along with subsequent chylothorax after partial nephrectomy. The patient underwent nutritional control, received octreotide treatment and had a complete recovery after 58 days. A damage to the cisterna chylic could account for the leakage. The chylothorax was a displacement through the diaphragmatic hiatus. Comprehensive review showed that near 30 % of such patients would require re-surgery or interventional treatment. The current case stresses the importance of careful examination, timely diagnostic test and appropriate treatment of abnormal drainage after nephrectomy.

摘要

肾切除术后腹膜后乳糜漏合并乳糜胸在临床实践中较为罕见。我们报告一例41岁女性,在部分肾切除术后出现严重的腹膜后乳糜漏并继发乳糜胸。患者接受营养控制、奥曲肽治疗,58天后完全康复。乳糜池损伤可能是漏出的原因。乳糜胸是通过膈裂孔移位所致。综合回顾显示,近30%的此类患者需要再次手术或介入治疗。本例强调了肾切除术后仔细检查、及时诊断性检查以及对异常引流进行恰当治疗的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5844/12125583/b45af54fa363/gr1.jpg

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