甲状腺癌术后右颈乳糜漏与颈部胸导管解剖变异

Right cervical chylous leakage and Anatomical variations of cervical thoracic duct after Thyroid Cancer surgery

摘要:

目的:结合文献分析颈部胸导管解剖变异特点及乳糜漏的治疗策略,为临床右颈乳糜漏发生的预防及其治疗的方法提供一定的借鉴作用。方法:报道1例年轻男性患者行甲状腺癌颈部淋巴结清扫术后发生右颈乳糜漏的病历资料,并通过中英文的数据库检索颈清术后发生乳糜漏的有关文献,联系其临床分析其发生较为少见的右颈乳糜漏的原因、探讨其最佳治疗方法。结论:颈清术后发生右侧乳糜漏较为少见,漏液量较为大者多由于其胸导管较正常解剖位置发生变异,且经保守治疗后漏液量>4000ml/d者,应尽早行手术治疗,胸腔镜下结扎不失为一种良好选择。

Abstract:

Objective: In combination with the literature analysis of the anatomical variation characteristics of the cervical thoracic catheter and the treatment strategy of celiac leakage, it provides a certain reference role for the prevention and treatment of clinical right cervical lacetic leakage. Methods: Report the medical record data of a young male patient who underwent thyroid cancer neck lymph node clearance after lymph node clearance of the right neck, and retrieve the relevant literature of lymphosis after cervical lymph node clearance through the Chinese and English database, analyse the reason for the rare right cervical lymph node clearance, and explore the best treatment method. Conclusion: It is rare to have leary leakage on the right side after cervical surgery. If the amount of fluid leakage is relatively large, it is often due to the mutation of the thoracic catheter compared with the normal anatomical position, and the leakage volume of >4000ml/d after conservative treatment should be surgically treated as soon as possible. Thoracoscopic ligation is a good choice.