DeHart M M, Lauerman W C, Conely A H, Roettger R H, West J L, Cain J E
Combined Integrated Spinal Research Unit, Wilford Hall Medical Center, Lackland AFB, Texas.
Spine (Phila Pa 1976). 1994 Mar 15;19(6):716-8. doi: 10.1097/00007632-199403001-00012.
Lymphatic complications are uncommon after spinal surgery. Postsurgical collections of lymph may result in chyloma, chylothorax, chylous ascites, or chyloretroperitoneum. Recommended treatment of chylothorax or chylous ascites includes drainage, and a low-fat diet using medium-chain triglyceride or total parenteral nutrition. The only reported case of chyloretroperitoneum concluded with a recommendation for retroperitoneal drainage. The authors present a series of three patients who underwent anterior spinal procedures complicated by retroperitoneal lymphatic injury. All three were treated without retroperitoneal drains, and at follow-up, none has shown any adverse sequelae from this method of treatment. The authors disagree with past recommendations for drainage of the retroperitoneal space because this may prolong drainage and deplete nutrition.
脊柱手术后淋巴管并发症并不常见。术后淋巴液积聚可能导致乳糜瘤、乳糜胸、乳糜腹水或乳糜性腹膜后积液。乳糜胸或乳糜腹水的推荐治疗方法包括引流，以及采用中链甘油三酯的低脂饮食或全胃肠外营养。唯一报道的乳糜性腹膜后积液病例以腹膜后引流的建议结束。作者报告了3例接受前路脊柱手术并发腹膜后淋巴管损伤的患者。所有3例患者均未放置腹膜后引流管进行治疗，随访时，无一例显示出这种治疗方法有任何不良后遗症。作者不同意过去关于腹膜后间隙引流的建议，因为这可能会延长引流时间并消耗营养。
