胸部肿瘤术后乳糜胸治疗的进展

Advances in the treatment of chylothorax after chest tumor surgery

乳糜胸是胸部肿瘤术后的严重并发症,其发病原因主要为术中损伤胸导管主干或侧枝,导致乳糜液外漏并积聚于胸腔引起。而大量乳糜液丢失会引起低蛋白血症、脂质丢失、电解质紊乱及胸腔积液,将引起重度营养不良、呼吸衰竭等严重并发症。近年来,随着外科技术和淋巴管介入技术的进步,精准的定位与微创手术相结合,减少了创伤,显著提高胸部肿瘤术后乳糜胸治疗的成功率,同时缩短患者的住院时间。本文拟根据相关研究,总结胸部肿瘤术后乳糜胸治疗的新进展。重点介绍近红外荧光胸腔镜胸导管显像技术、经皮胸导管栓塞术、经腹乳糜池缝扎术等乳糜胸治疗的新技术。

Chylothorax is a severe complication following thoracic tumor surgery,primarily caused by intraoperative damage to the thoracic duct or its branches,leading to the leakage and accumulation of chyle in the pleural cavity.The substantial loss of chyle can result in hypoproteinemia,loss of lipids,electrolyte imbalances,and pleural effusion,causing severe complications such as malnutrition and respiratory failure.In recent years,with advancements in surgical techniques and lymphatic intervention technology,the combination of precise localization and minimally invasive surgery has reduced trauma,significantly improving the success rate of chylothorax treatment after thoracic tumor surgery,and shortening the patient’s hospital stay.This article aims to summarize the latest advancements in the treatment of chylothorax post-thoracic tumor surgery based on relevant studies.It will focus on introducing new techniques for chylothorax treatment,including near-infrared fluorescence imaging of thoracic duct,percutaneous thoracic duct embolization,and laparoscopic ligation of cisterna chyli.