食管癌切除术后乳糜胸(附11例治疗体会)

Postoperative Chylothorax Caused By Esophageal Carcinoma Resection——Experience in Treatment of 11 Cases

目的 分析食管癌切除术后发生乳糜胸的有关因素,研究乳糜胸的诊断、治疗原则及预防措施。方法 回顾我院1988年2月～1999年11月856例食管癌切除及11例术后乳糜胸病例,重点分析手术方式与乳糜胸的关系,术后乳糜胸再次手术的时机及胸导管结扎的方法。结果 11例术后乳糜胸病人,1例经保守治疗而治愈,10例经再次手术而治愈。结论 术后乳糜胸,每日胸液引流量大于800ml,观察7天后未减少应及时再次手术;食管癌切除,术中作预防性胸导管结扎。

Objective To analyze the correlative factors of chylothorax and study on its diagnosis,principle of treatment and preventive measures after the resection of esophageal carcinoma.Methods Retrospective study on 856 cases of esophageal carcinoma resections performed in our hospital from Feb.1988 to Nov.1999 and 11 cases of postoperative chylothorax.Analyze the relation between operative methods for resection of esophageal carcinoma and the occurrence of chylothorax,the suitable time for operative treatment of chylothorax and the proper method of thoracic duct ligation.Results Among 11 postoperative chylothorax,1 case were cured by conservative and 10 cases were cured by operative treatments.Conclusion For postoperative chylothorax,if the amount of thoracic drainage fluid exceeds 800ml per day for 7days without reduction, it should be treated by surgical operation in time. Preventive surgical ligation of thoracic duct during the course of esophageal carcinoma resection can reduce the incidence of postoperative chylothorax.