完整结肠系膜切除术后四例乳糜漏临床分析  

Chylous leakage after complete mesocolic excision of colon cancer

作　　者：田颖[1] 叶颖江[2] 高志冬[2] 王杉[2] 

机构地区：[1]北京市肛肠医院(二龙路医院) [2]北京大学人民医院

出　　处：《中华普外科手术学杂志（电子版）》2012年第2期15-17,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：首都临床特色应用研究项目(Z111107058811046)

摘　　要：目的总结完整结肠系膜切除术所致4例乳糜漏诊治经验。方法回顾性分析2009年11月至2011年12月收治的61例因结肠癌行完整结肠系膜切除术中4例术后并发乳糜漏患者的临床资料。结果 61例患者中有4例术后发生乳糜漏,发生率为6.6%,右半结肠发生率100%,肿瘤分期Ⅱ期3例,Ⅲ期1例。发生乳糜漏的时间平均为术后第5(4～6)天,每日最大引流量285～490ml,平均380ml。全部患者经保守治疗痊愈。结论完整结肠系膜切除术后乳糜漏多发生在右半结肠,以Ⅱ期、Ⅲ期结肠癌为主。避免发生术后乳糜漏应以术中预防为主;治疗首选支持及保守治疗。Objective To summarize the clinical experience in 4 patients and to investigate the effective management of chylous leakage caused by complete mesocolic excision（CME） of colon cancers. Methods between November 2009 and December 2011, 61 patients who had undergone CME for colon cancers were included in the study. In the 61 patients, the clinical data of 4 patients who had postoperative ehylous leakage were analyzed. Results The incidence of ehylous leakage after CME was 6.6% （4/61）. In the 4 patients, tumors were located in the fight hemi-colon, and tumor staging was phase Ⅱ in 3 patients and phase Ⅲ in 1 patient. Chylous leakage occurred at an average of 5 （ 4 - 6 ） days after operation. The maximum daily drainage volume ranged from 285 to 490 mL, with an average of 380 mL. The 4 patients were cured conservatively. Conclusions Chylous leakage often occur in the fight hemieolon after complete mesocolic excision （CME）, especilly in patients with phase ⅡX and Ⅲ staging. Postoperative chylous leakage should be avoided by intraoperative prevention. Once chylous leakage occurs, support and conservative treatment should be carried out.

关 键 词：结肠肿瘤 手术后并发症 乳糜性腹水 完整结肠系膜切除术 

分 类 号：R735.35[医药卫生—肿瘤]