盆腹腔淋巴切除术后淋巴漏的诊治现状

The Diagnosis and Treatment of Lymphatic Leakage after Gynecological Pelvic Surgery

淋巴漏是妇科盆腔术后常见的并发症,对于存在肥胖、贫血、术中出血过多及淋巴结肿大等高危因素的患者,应给予足够重视。淋巴漏发生后应首选保守治疗,包括禁食、营养支持、药物治疗等;对于保守治疗不佳的难治性患者,可考虑手术或介入治疗,目前超声引导下结内淋巴管造影术不失为一种可选择的方法。本文回顾盆腹腔淋巴系统的解剖及生理,分析妇科术后淋巴漏的形成原因、高危因素、治疗方法及预防措施,以期为临床医生提供指导和帮助.

Lymphatic leakage is one of the postoperative complications in gynecologic malignancies,which we need to pay more attention to,especially for patients with higher-risk factors,such as obesity,anemia,excessive intraoperative blood loss and lymphadenectasis.Conservative methods are preferred after lymphatic leakage,including fasting,nutritional support,drug therapy,etc.For patients irresponsive to conservative methods,surgical treatment may be considered;ultrasound-guided intracranial lymphangiography is also a good alternative.In this article,we will review the anatomy and physiology of the lymphatic system,discuss the causes and high-risk factors of lymphatic leakage after gynecological pelvic surgery,and systematically elaborate the treatment methods and preventive measures based on our clinical experience.