腹腔镜治疗妇科恶性肿瘤术后淋巴漏的临床分析

Clinical analysis of the lymphorrhagia after laparoscopic gynecologic surgery of tumors

目的:探讨腹腔镜治疗妇科恶性肿瘤手术后淋巴漏的发生、诊断、治疗和预防措施。方法:回顾分析2005年1月～2011年5月我院腹腔镜治疗妇科恶性肿瘤129例手术的临床资料。结果:129例患者中7例发生淋巴漏,发病率为5.4%。7例患者临床表现为术后3～7d出现持续大量引流液,每日引流量为300～1500ml,5例为淡黄色引流液,2例为乳糜样引流液。7例患者均通过禁食或限制饮食、静脉营养等保守治疗成功。结论:淋巴漏作为一种手术并发症在腹腔镜治疗妇科恶性肿瘤术后并不罕见,其临床症状依据发生位置不同而表现各异,大多数患者可通过保守治疗治愈。术中轻柔操作、提高手术技巧及对高危患者预防性禁食可预防淋巴漏的发生。

Objective：To investigate the incidence,diagnosis,treatment and prevention of lymphorrhagia after laparoscopic gynecologic surgery of tumors.Methods：A retrospective analysis was made on clinical data of 129 cases of laparoscopic gynecologic surgery of tumors from January 2005 to May 2011 in the hospital.Results： Seven cases among 129 cases of laparoscopic surgery of tumors were detected with lymphorrhagia,and the rate was 5.4%.The 7 patients represented persistent massive drainage ranging from 300ml to 1500ml per day,including 5 cases with clear yellow fluid and 2 cases with chylous ascites.All 7 patients were cured with expectant treatment consisting of fast or diet and intravenous nutrition.Conclusion：As a postoperative complication of laparoscopic gynecologic surgery of tumors,lymphorrhagia was not rare.The clinical manifestations of lymphorrhagia were various.Most of these patients recovered with conservative treatment.To reducing the occurrence of lymphorrhagia,careful surgical techniques should be recommended and absolute fast should be valuable for high risk patients.