Jiang Yingying, Yao Zhichao, Zhou Dayong, Liu Zhanao
Department of Operating Room, Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China.
Department of Vascular surgery, Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, 26 Daoqian Road, Suzhou, Jiangsu, 215002, China.
BMC Surg. 2025 Aug 7;25(1):349. doi: 10.1186/s12893-025-03113-2.
To investigate the effectiveness and safety of preoperative fat meal administration in patients undergoing thoracic duct reconstruction for chylous leakage due to thoracic duct outlet obstruction.
A retrospective study was conducted on 18 patients diagnosed with thoracic duct outlet obstruction who underwent thoracic duct reconstruction between January 2022 and August 2024. Patients were administered a fat meal before surgery. The time interval between ingesting the fat meal and the exposure of the thoracic duct was recorded. Additionally, the appearance of the thoracic duct, the operating time duration, and any injuries to the thoracic duct or lymphatic branches were recorded.
11 patients' thoracic ducts were exposed within 6-8 h after the fat meal, of which nine patients exhibited a milky white thoracic duct. The average surgical duration was 126.82 ± 53.30 min, and no injuries to the thoracic duct or its branches occurred in these patients. Additionally, seven patients' thoracic ducts were exposed more than eight hours after a fat meal, among which only three patients had a milky white appearance of the thoracic duct. The average surgical duration for these patients was 180.00 ± 48.31 min ( P < 0.05), and injuries to the thoracic duct and its branches occurred in two patients. All patients achieved favourable therapeutic outcomes after thoracic duct reconstruction surgery.
Preoperative fat meals appear to enhance intraoperative visualization of the cervical segment of the thoracic duct during reconstructive surgery for thoracic duct obstruction, potentially contributing to reduced operative times and decreased incidence of iatrogenic thoracic duct injuries.
探讨术前给予脂肪餐对因胸导管出口梗阻导致乳糜漏而接受胸导管重建手术患者的有效性和安全性。
对2022年1月至2024年8月期间诊断为胸导管出口梗阻并接受胸导管重建手术的18例患者进行回顾性研究。患者在手术前给予脂肪餐。记录摄入脂肪餐与胸导管暴露之间的时间间隔。此外，记录胸导管的外观、手术持续时间以及胸导管或淋巴分支的任何损伤情况。
11例患者在脂肪餐后6 - 8小时内暴露胸导管，其中9例患者的胸导管呈乳白色。平均手术时间为126.82 ± 53.30分钟，这些患者未发生胸导管或其分支的损伤。此外，7例患者在脂肪餐后8小时以上暴露胸导管，其中只有3例患者的胸导管呈乳白色。这些患者的平均手术时间为180.00 ± 48.31分钟（P < 0.05），2例患者发生胸导管及其分支的损伤。所有患者在胸导管重建手术后均取得了良好的治疗效果。
术前脂肪餐似乎能在胸导管梗阻重建手术中增强术中对胸导管颈段的可视化，可能有助于缩短手术时间并降低医源性胸导管损伤的发生率。
