胃癌根治术后腹腔淋巴漏的诊治(附4例临床分析)

Clinical Analysis of Lymphatic Fistulas after Radical Surgical Treatment for Gastric Cancer

目的:探讨胃癌根治手术后腹腔淋巴漏的发生原因及治疗方法。方法:对本院1992年4月至2002年4月胃癌根治术后发生腹腔淋巴漏4例患者的临床资料进行回顾分析。结果:胃癌根治术后腹腔淋巴漏发生率为0.9%(4/442),全部病例均经非手术治疗痊愈。手术后引流量300ml^1600ml/日,平均900ml/日。引流时间15天~37天,平均26天。结论:胃癌根治手术在进行腹膜后淋巴管网的清扫时,应重视残余管网的结扎,预防淋巴漏的发生,一旦出现淋巴漏则多可经保守疗法治愈。

Objective： To inverstigate the causes and treatments of lymphatic fistulas after radical surgical treatment for gastric cancer. Methods： The clinical data of 4 cases with lymphatic fistulas after radical surgical treatment for gastric cancer from April 1992 to April 2002 were analyzed retrospectively. Results： The incidence rate of lymphatic fistulas after radical surgical treatment for gastric cancer was 0.9% （4/442） , all of the four cases were cured by non-surgical treatments. The mean volume of drain after radical surgical treatment was 900 ml/d （300ml/d - 1600ml/d） ,and the mean time of drain was 26 days （ 15days -37days）. Conclusion： It is emphasised to ligate lymphatic vessels in radical surgical treatment for gastric cancer to avoid lymphatic fistldas. Non-surgical theatments can usually cure lymphatic fistulas after radical surgical treatment for gastric cancer.