Verhoeven W, Low C O, See H F, Chacha P B, Tan N C
Department of Orthopaedics, Toa Payoh Hospital, Singapore.
Ann Acad Med Singap. 1996 Mar;25(2):286-8.
We report a case of massive chylothorax occurring postoperatively in a patient with Potts paraplegia who underwent transthoracic anterior debridement and fusion of the T7 and T8 vertebrae. This is an uncommon complication of anterior spinal surgery but has a significant morbidity and mortality. Diagnosis of the condition and the institution of the appropriate therapy will reduce this significantly. The treatment principles are continuous tube drainage, nutritional support and reduction of chyle production. In 50% of cases a surgical procedure will be required. There are a variety of techniques available. We describe a technique that uses a pedicled intercostal muscle flap, which to our knowledge, has not been described previously. Among the other techniques, video-assisted thoracoscopic surgery is the most promising because of its low morbidity.
我们报告了一例患有波特氏截瘫的患者，在接受经胸前路T7和T8椎体清创融合术后发生大量乳糜胸的病例。这是脊柱前路手术罕见的并发症，但具有较高的发病率和死亡率。对该病症的诊断和采取适当的治疗措施将显著降低发病率和死亡率。治疗原则是持续胸腔闭式引流、营养支持以及减少乳糜生成。50%的病例需要进行手术，有多种手术技术可供选择。我们描述了一种使用带蒂肋间肌瓣的技术，据我们所知，此前尚未有过相关描述。在其他技术中，电视辅助胸腔镜手术因其低发病率而最具前景。
