Wakim R, Bellamy J, Irani M
Service de Chirurgie viscérale, Hopital Delafontaine, Saint Denis.
Ann Chir. 1995;49(9):863-8.
Chylothorax is a rare complication of thoracic surgery. The chyle leak can induce serious metabolic and immunological disorders. The ideal treatment of chylothorax has not been clearly established, and opinions are still divided between medical treatment and early or late surgical reoperation after prolonged medical treatment. Out of a total of 1.750 thoracic operations performed at the Centre Chirurgical du Val d'Or over the last 10 years, six cases of chylothorax were reoperated early, an average of five days after the initial operation. The chyle leak was easy to localize in every case. The second operation was performed via the same initial incision. All six patients has an uneventful postoperative course and only one case had a persistent chyle leak which gradually resolved. The mean total hospital stay was 18 days. No systemic infections or deaths were recorded. Early reoperation avoids the complications of prolonged medical treatment, is technically easy and decreases the length of hospital stay.
乳糜胸是胸外科手术中一种罕见的并发症。乳糜漏可引发严重的代谢和免疫紊乱。乳糜胸的理想治疗方法尚未明确确立,对于保守治疗以及保守治疗延长后早期或晚期再次手术,各方观点仍存在分歧。在过去10年里,瓦尔多尔中心外科共进行了1750例胸科手术,其中6例乳糜胸患者在初次手术后平均5天就接受了早期再次手术。在每一例中,乳糜漏都很容易定位。第二次手术通过最初的同一切口进行。所有6例患者术后恢复顺利,只有1例存在持续乳糜漏,但逐渐好转。平均总住院天数为18天。未记录到全身性感染或死亡病例。早期再次手术可避免保守治疗延长带来的并发症,技术操作简便,还能缩短住院时间。