选择性胸导管结扎预防食管癌术后乳糜胸的临床研究  

Selective Thoracic Duct Ligation in the Prevention of Chylothorax after Radical Resection of Esophageal Carcinoma

作　　者：肖平 王祥 廖鹏强 杨晓樽 谢天鹏 向润 胡彬 戴维 庄翔 Xiao Ping;Wang Xiang;Liao Pengqiang;Yang Xiaozun;Xie Tianpeng;Xiang Run;Hu Bin;Dai Wei;Zhuang Xiang(Department of Thoracic Surgery,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,School of Medicine,University of Electronic Science and Technology of China,Chengdu 610041,Sichuan,China)

机构地区：[1]四川省肿瘤医院·研究所,四川省癌症防治中心,电子科技大学医学院胸外科,成都610041

出　　处：《肿瘤预防与治疗》2021年第8期726-730,共5页Journal of Cancer Control And Treatment

基　　金：四川省卫生和计划生育委员会科技计划项目(编号:2018SZ0210)。

摘　　要：目的:评价选择性胸导管结扎预防食管癌术后乳糜胸的临床效果。方法:回顾性分析2017年1月至2020年6月在四川省肿瘤医院胸外科中心接受食管鳞癌手术治疗的共计212例病例资料,2018年6月之前接受胸导管结扎的96例患者为对照组,2018年6月之后接受选择性胸导管结扎的116例患者为观察组。比较两组患者临床资料和术后乳糜胸发生率的差异。结果:两组患者在平均年龄、性别比、肿瘤部位、病理分期、术前新辅助治疗、手术方式、术中淋巴结清扫数目、手术时间、术中出血量的差异无统计学意义(P>0.05)。观察组和对照组在术后乳糜胸的发生率分别为3.45%和5.21%,再次手术率分别为1.72%和1.04%,差异均无统计学意义(P>0.05)。结论:选择性胸导管结扎安全、简单、有效,同时最大限度保留了胸导管的生理功能,减少了结扎后可能给患者带来的营养代谢问题。Objective:To evaluate the clinical effect of selective thoracic duct ligation in preventing chylothorax after radical resection of esophageal carcinoma.Methods:We retrospectively analyzed the data of 212 cases who had received surgical treatment for esophageal squamous cell carcinoma in the department of thoracic surgery in Sichuan Cancer Hospital from January 2017 to June 2020.96 cases who underwent thoracic duct ligation before June 2018 were assigned to the control group,and 116 cases who underwent selective thoracic duct ligation after June 2018 were assigned to the observation group.Clinical data and incidence rates of chylothorax were compared between two groups.Results:There were no statistically significant differences between the two groups in average age,sex ratio,location of tumor,pathology stage,preoperative neoadjuvant therapy,surgical methods,number of lymph nodes,operation time and blood loss(P>0.05).The incidence of chylothorax was 3.45%in the observation group and 5.21%in the control group(P>0.05),and the reoperation rates was 1.72%in the observation group and 1.04%in the control group(P>0.05).Conclusion:Selective thoracic duct ligation before operation of esophageal cancer is safe,simple and effective,which retains the physiological function of the thoracic duct to a large extent,reducing the nutritional and metabolic problems of patients after the ligation.

关 键 词：食管肿瘤 胸导管结扎术 乳糜胸 

分 类 号：R730.6[医药卫生—肿瘤] R735.1[医药卫生—临床医学]