胸腔镜下胸导管结扎术治疗甲状腺术后顽固性淋巴漏  

Thoracoscopic thoracic duct ligation for refractory lymphatic leakage after thyroidectomy

作　　者：李朋[1] 梁青壮 王东来[1] 韩彬[1] 易辛[1] 韦伟[1] LI Peng;LIANG Qingzhuang;WANG Donglai;HAN Bin;YI Xin;WEI Wei(The Department of Breast and Thyroid Surgery,Peking University Shenzhen Hospital,Shenzhen,Guang⁃dong 518036)

机构地区：[1]北京大学深圳医院乳腺甲状腺外科

出　　处：《岭南现代临床外科》2019年第6期697-700,共4页Lingnan Modern Clinics in Surgery

基　　金：广东省深圳市三名工程资助项目(SZSM201612010)

摘　　要：目的探讨胸腔镜下胸导管结扎术治疗甲状腺术后顽固性淋巴漏的安全性和可行性。方法 2例甲状腺术后淋巴漏患者,第1例保守治疗无效和颈部探查失败,第2例为全乳晕腔镜甲状腺术后患者且保守治疗无效。均实施了胸腔镜下胸导管结扎手术。结果 2例患者术后颈部引流液均骤然减少,术后48小时拔除颈部引流管。出院后随访3个月均无胃肠道消化吸收功能障碍和免疫力低下的临床表现。结论胸腔镜下胸导管结扎术安全有效,适用于甲状腺术后顽固性淋巴漏的治疗。Objective To explore the safety and feasibility of thoracic duct ligation under thoracoscope in the treatment of refractory lymphatic leakage after thyroidectomy.Methods Two cases of lymphatic leakage after thyroidectomy,the first case was invalid conservative treatment and failed neck exploration,the second case was invalid conservative treatment after total areola endoscopic thyroidectomy.All patients were underwent thoracoscopic thoracic duct ligation.Results The cervical drainage fluid decreased dramatically in 2 patients,and the cervical drainage tube was removed 48 hours after operation.There were no clinical manifestations of gastrointestinal digestive and absorption dysfunction and low immunity after 3 months of follow-up.Conclusion Thoracoscopic thoracic duct ligation is safe and effective,and is suitable for the treatment of intractable lymphatic leakage after thyroid surgery.

关 键 词：甲状腺手术 顽固性淋巴漏 胸腔镜 胸导管结扎术 

分 类 号：R653[医药卫生—外科学]