Nakano A, Kato M, Watanabe T, Kawai N, Ota H, Hattori T, Kobayashi Y, Nimura Y
First Department of Surgery, Nagoya University School of Medicine, Japan.
Hepatogastroenterology. 1994 Dec;41(6):568-70.
A 52-year-old woman with thoracic esophageal carcinoma was admitted to our hospital. Standard radical esophagectomy was carried out via a right posterolateral thoracotomy and laparotomy. A drainage tube was removed from the right side of the chest on the 9th postoperative day. Three days later a chest roentgenogram showed massive left pleural effusion, and a tube was inserted into the left pleural cavity. The volume of the effusion was 900 ml/day and chylothorax was diagnosed. Conservative therapy was applied for 30 days, but chyle leakage persisted. Intra-pleural infusion of OK-432, a Su-strain of Streptococcus pyogenes, and doxycycline hydrochloride was carried out to seal the leakage point. The effusion stopped immediately after the procedure. There were no major side effects. This procedure should be considered the treatment of choice for patients with persistent chylothorax not responding to initial conservative management.
一名52岁的胸段食管癌女性患者入住我院。通过右后外侧开胸和剖腹手术进行了标准根治性食管切除术。术后第9天从右侧胸部拔除引流管。三天后胸部X线片显示大量左侧胸腔积液，遂在左侧胸腔置入一根引流管。积液量为每天900毫升，诊断为乳糜胸。进行了30天的保守治疗，但乳糜漏持续存在。向胸腔内注入化脓性链球菌的Su株OK-432和盐酸多西环素以封闭漏点。注入后积液立即停止。无重大副作用。对于初始保守治疗无效的持续性乳糜胸患者，该方法应被视为首选治疗方法。
