摘要
目的分析术中结扎胸导管对不同部位胸段食管癌患者手术后预防发生乳糜胸的作用。方法对2003年3月至2007年6月手术切除的胸段食管癌243例患者的临床资料进行回顾性分析。根据不同病变部位将患者分为上段、中上段、中段、中下段和下段5组，了解不同部位胸段食管癌患者术中结扎和不结扎胸导管与术后乳糜胸发生有无相关性。结果术后共计8例患者出现乳糜胸，总发生率3．3％。上段病变结扎组乳糜胸发生3例，未结扎组5例；中上段病变结扎组和未结扎组均未发生乳糜胸；中段病变未结扎组1／28（3．6％）；中下段病变结扎组乳糜胸发生率1／39（2．6％），未结扎组1／35（2．9％）；下段病变结扎组乳糜胸发生率1／37（2．7％），未结扎组2／44（4．5％）。Logistic回归分析显示。不同部位胸段食管癌切除术中是否结扎胸导管结扎对术后乳糜胸的发生均无影响（P〉0．05）。结论预防性结扎胸导管不能降低不同部位胸段食管癌术后继发乳糜胸的发生率。
Objective To investigate the effect of thoracic duct ligation during transthoracic esophagectomy on preventing post-operative chylothorax in different tuma locations. Methods Between March 2003 and June 2007, 243 patients with thoracic esophageal carcinoma underwent esophageal resection in our hospital. All the cases were divided into five groups according to tumor localization, including cervical, upper middle, middle, lower middle and lower sections. Each was then subdivided into 2 groups： with and without intraoperative thoracic duct ligation. Statistical analysis was carried out to evaluate the relevance between ligation and non-ligation of the thoracic duct during esophagectomy and the incidence of pest-operative chylothorax. Results A total of 8 cases of post-operative chylothorax was recorded and the incidence was 3.3%. Incidence with respect to tumor location was as follows： cervical section： ligation subgroup 3 cases and non-ligation subgroup 5 cases; upper middle section： no one for both ligation and non-ligation subgroups; middle section： ligation subgroup 0/26 and non-ligation subgroup 1/28（3.6%）; lower middle section： ligation subgroup 1/39（2.6%） and non- ligation subgroup 1/35（2.9%）; lower section： ligation subgroup 1/37（2.7%） and non-ligation subgroup 2/44 （4.5%）. Logistic regression analysis revealed no significant difference between ligation and non- ligation subgroup in the prevention of pest-operative chylothorax （P 〉 0.05）. Conclusion Thoracic duct ligation as preventive measure can not decrease the incidence of chylothorax secondary to esophagectomy.
出处
《中华胃肠外科杂志》
CAS
2008年第1期36-38,共3页
Chinese Journal of Gastrointestinal Surgery
关键词
食管肿瘤
乳糜胸
胸导管
治疗结果
Esophageal neoplasms
Chylothorax
Thoracic duct
Treatment outcome
