Background: Inguinal lymph node dissections (ILND) have been commonly associated with postoperative complications such as lymphedema, lymph fistula and wound infections. The reported complication rates after ILND rang...Background: Inguinal lymph node dissections (ILND) have been commonly associated with postoperative complications such as lymphedema, lymph fistula and wound infections. The reported complication rates after ILND range from 14% - 77%, and a rationale for these large differences is the use of a variety of different definitions of complications. Patients and Methods: Files of patients that underwent inguinal lymph node dissection for lymph node metastases at the Department of General and Visceral Surgery of the University Hospital Frankfurt between February 2005 and March 2012 were retrospectively reviewed. Results: 47 patients (65%) developed a lymphatic fistula in the course of the operation, of which 6 patients (8%) underwent reoperations. Surgical side infections (SSI) were seen in 15 patients (21%), all of them harbouring fistulas. Patients presenting with a BMI ≥ 30 kg/m2 did not develop more fistulas than those with a BMI 2 (p = 0.30). Patients who suffered from a lymph fistula had significantly more visits in the outpatient clinic (p =< 0.0001). There was no difference in the complication rate if the procedure was performed by a resident under supervision or a senior surgeon (p = 0.79). Conclusion: In this study, we demonstrated that lymph fistulas are to date a common complication after ILND and lead to reoperations and significantly more outpatient visits. The number of lymph nodes affected and resected, and prior sentinel lymph node dissection, was not associated with a higher complication rate.展开更多
目的:探讨甲状腺癌中央区淋巴结清除术后乳糜漏发生的原因及有效的防治措施。方法:选取天津医科大学肿瘤医院2013年7月至2015年6月6 127例甲状腺癌中央区淋巴结清除术病例,其中14例患者术后并发乳糜漏。采取全身治疗、局部加压包扎、常...目的:探讨甲状腺癌中央区淋巴结清除术后乳糜漏发生的原因及有效的防治措施。方法:选取天津医科大学肿瘤医院2013年7月至2015年6月6 127例甲状腺癌中央区淋巴结清除术病例,其中14例患者术后并发乳糜漏。采取全身治疗、局部加压包扎、常压引流、50%葡萄糖注射液或平阳霉素经引流管注入等保守治疗,保守治疗效果不理想时行手术治疗。结果:12例患者行保守治疗后,引流量逐渐减少,至<10 m L/d时拔除引流管;2例患者保守治疗后,引流量未见明显减少,行手术治疗。结论:甲状腺癌中央区淋巴结清除术时应仔细操作以预防乳糜漏的发生,发生后行保守治疗,保守治疗无效时行手术治疗。展开更多
文摘Background: Inguinal lymph node dissections (ILND) have been commonly associated with postoperative complications such as lymphedema, lymph fistula and wound infections. The reported complication rates after ILND range from 14% - 77%, and a rationale for these large differences is the use of a variety of different definitions of complications. Patients and Methods: Files of patients that underwent inguinal lymph node dissection for lymph node metastases at the Department of General and Visceral Surgery of the University Hospital Frankfurt between February 2005 and March 2012 were retrospectively reviewed. Results: 47 patients (65%) developed a lymphatic fistula in the course of the operation, of which 6 patients (8%) underwent reoperations. Surgical side infections (SSI) were seen in 15 patients (21%), all of them harbouring fistulas. Patients presenting with a BMI ≥ 30 kg/m2 did not develop more fistulas than those with a BMI 2 (p = 0.30). Patients who suffered from a lymph fistula had significantly more visits in the outpatient clinic (p =< 0.0001). There was no difference in the complication rate if the procedure was performed by a resident under supervision or a senior surgeon (p = 0.79). Conclusion: In this study, we demonstrated that lymph fistulas are to date a common complication after ILND and lead to reoperations and significantly more outpatient visits. The number of lymph nodes affected and resected, and prior sentinel lymph node dissection, was not associated with a higher complication rate.
文摘目的:探讨甲状腺癌中央区淋巴结清除术后乳糜漏发生的原因及有效的防治措施。方法:选取天津医科大学肿瘤医院2013年7月至2015年6月6 127例甲状腺癌中央区淋巴结清除术病例,其中14例患者术后并发乳糜漏。采取全身治疗、局部加压包扎、常压引流、50%葡萄糖注射液或平阳霉素经引流管注入等保守治疗,保守治疗效果不理想时行手术治疗。结果:12例患者行保守治疗后,引流量逐渐减少,至<10 m L/d时拔除引流管;2例患者保守治疗后,引流量未见明显减少,行手术治疗。结论:甲状腺癌中央区淋巴结清除术时应仔细操作以预防乳糜漏的发生,发生后行保守治疗,保守治疗无效时行手术治疗。
