肺癌术后乳糜胸防治策略

The prevention and management strategy for chylothorax post operation of lung cancer

〔目的〕探讨肺癌术后乳糜胸的防治策略。〔方法〕从2012年4月至2016年3月,我科行各种肺癌肺切除术2 126例,术后发生乳糜胸6例,发生率0.28%。其中,右侧5例,左侧1例。我们回顾性分析此6例乳糜胸的诊断治疗经验,并对其发生和预防策略进行了探讨。〔结果〕5例保守治疗成功,1例右侧开胸手术者,因引流量大,经短期保守治疗无效,原切口开胸行胸导管结扎术治愈。〔结论〕癌术后乳糜胸多可保守治愈,引流量大短期保守治疗无效需行胸导管结扎术或经VATS行胸导管夹闭术。可疑有胸导管或其分支损伤时,应行预防性胸导管结扎术,以防术后乳糜胸的发生。

〔Objective 〕To estimate the prevention and management methods for chylothorax post operation of lung cancer.〔Methods〕From April 2012 to March 2016, a continuous of 2 126 cases of lung cancer were adopted operation in our department. A total of 6 cases of chylothorax happened after operation and the happen rate was 0.28%. Among them, Five cases happened in right chest while 1 case appeared in left side. The paper retrospectively reviewed the experiences of the prevention and management for these patients and investigated the possible reasons and measures to avoid it to happen.〔Results〕Five cases of chylothorax patients were cured by conservative methods,while one case cured by tied the ductus thoracicus through the original right approach due to large amounts of thoracic drainage.〔Conclusion〕Most of chylothorax caused by lung cancer operation could been cured through conservative measures. For the case whom had large amounts of thoracic drainage, through the original approach or through VATS to tie the ductus thoracicus should been done after a short period of observation. For patient whom suspicious had damaged the ductus thoracicus or its branch, the main trunk of it should been preventative tied to prevent the happen of chylothorax post operation.