甲状腺癌颈清扫术后淋巴漏39例分析

梅洁; 苏新良

doi:10.16016/j.1000-5404.201608138

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甲状腺癌颈清扫术后淋巴漏39例分析

临床医学 | 更新时间：2026-01-09

- 甲状腺癌颈清扫术后淋巴漏39例分析
- Lymphatic leakage after neck dissection for thyroid cancer: an analysis of 39 cases
- 第三军医大学学报 2017年39卷第4期页码：385-389
- 作者机构：
- 作者简介：
- 基金信息：
  
  重庆市卫生局科研计划项目(2010-2-017)
- DOI：10.16016/j.1000-5404.201608138
  中图分类号：
- 收稿：2016-08-24，
  
  纸质出版：2017-02-28
- 稿件说明：
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梅洁, 苏新良. 甲状腺癌颈清扫术后淋巴漏39例分析[J]. 第三军医大学学报, 2017,39(4):385-389.

Jie Mei, Xinliang Su. Lymphatic leakage after neck dissection for thyroid cancer: an analysis of 39 cases[J]. J Third Mil Med Univ, 2017, 39(4): 385-389.
梅洁, 苏新良. 甲状腺癌颈清扫术后淋巴漏39例分析[J]. 第三军医大学学报, 2017,39(4):385-389. DOI： 10.16016/j.1000-5404.201608138.

Jie Mei, Xinliang Su. Lymphatic leakage after neck dissection for thyroid cancer: an analysis of 39 cases[J]. J Third Mil Med Univ, 2017, 39(4): 385-389. DOI： 10.16016/j.1000-5404.201608138.

摘要

Abstract

Objective

To discuss the prevention and management of postoperative lymphatic leakage after neck dissection in patients with thyroid cancer.

Method

Retrospective review was performed in 1 104 cases of patients with thyroid cancer who underwent neck dissection in our from January 2013 to December 2015．Clinical data of the patients with postoperative lymphatic leakage were summarized and analyzed.

Result

Thirty-nine cases developed lymphatic leakage after neck dissection，accounting for 3.5% of total cases. Among them

27 cases were mild

3 cases were moderate

and 9 cases were severe.The patients who underwent left-sided neck dissection were more likely to occur lymphatic leakage than the patients who had the dissection in the right-side neck. The majority of patients were cured by a variety of conservative treatments

except 2 severe cases. Both underwent reoperation

and one of them were treated with local injection of pseudomonas aeruginosa after the failure of reoperation. No complications such as infection or serious water-electrolyte disorder occurred.

Conclusion

Prevention plays a key role in the management of lymphatic leakage，particularly in the left-sided neck dissection. Most patients can be cured by conservative treatment including continuous negative pressure drainage and pumping of somatostatin

and combination of intracavitary injection of pseudomonas aeruginosa enables to accelerate the closure of chylous fistula. In a few patients with longer duration of lymphatic leakage，large volume of drainage and failed conservative therapy

reoperation is considered but with special caution due to high risk of surgery.

关键词

Keywords

references

Nowak K Wierzbicka M Szyfter W Chylous leakage--rare but still dangerous complication after neck surgery Otolaryngol Pol 2011 65 2 128 131 10.1016/S0030-6657(11)70642-4 Nowak K, Wierzbicka M, Szyfter W. Chylous leakage--rare but still dangerous complication after neck surgery[J]. Otolaryngol Pol, 2011, 65(2): 128-131.DOI: 10.1016/S0030-6657(11)70642-4

Campisi C C Boccardo F Piazza C Evolution of chylous fistula management after neck dissection Curr Opin Otolaryngol Head Neck Surg 2013 21 2 150 156 10.1097/MOO.0b013e32835e9d97 Campisi C C, Boccardo F, Piazza C, et al. Evolution of chylous fistula management after neck dissection[J]. Curr Opin Otolaryngol Head Neck Surg, 2013, 21(2): 150-156.DOI: 10.1097/MOO.0b013e32835e9d97

Ahn D Sohn J H Jeong J Y Chyle Fistula After Neck Dissection: An 8-Year, Single-Center, Prospective Studyof Incidence, Clinical Features, and Treatment Ann SurgOncol 2015 22 Suppl 3 S1000 S1006 10.1245/s10434-015-4822-7 Ahn D, Sohn J H, Jeong J Y. Chyle Fistula After Neck Dissection: An 8-Year, Single-Center, Prospective Studyof Incidence, Clinical Features, and Treatment[J]. Ann SurgOncol, 2015,22(Suppl 3): S1000-S1006. DOI:10.1245/s10434-015-4822-7

林秀安刘畅甲状腺癌颈淋巴清扫术并发乳糜瘘的防治中国肿瘤外科杂志 2015 7 5 299 300 10.3969/j.issn.1674-4136.2015.05.007 林秀安, 刘畅. 甲状腺癌颈淋巴清扫术并发乳糜瘘的防治[J]. 中国肿瘤外科杂志, 2015, 7(5): 299-300,301. DOI:10.3969/j.issn.1674-4136.2015.05.007

陈朔许乙凯 Karki B 胸导管的磁共振水成像研究国际医学放射学杂志 2012 35 6 533 535 10.3784/j.issn.1674-1897.2012.06.Z0605 陈朔, 许乙凯, Karki B, 等. 胸导管的磁共振水成像研究[J]. 国际医学放射学杂志, 2012, 35(6): 533-535,552. DOI:10. 3784 /j. issn. 1674-1897. 2012. 06. Z0605

Johnson O W Chick J F Chauhan N R The thoracic duct: clinical importance, anatomic variation, imaging, and embolization Eur Radiol 2016 26 8 2482 2493 10.1007/s00330-015-4112-6 Johnson O W, Chick J F, Chauhan N R, et al. The thoracic duct: clinical importance, anatomic variation, imaging, and embolization[J]. Eur Radiol, 2016, 26(8): 2482-2493. DOI:10.1007/s00330-015-4112-6

Shimada K Sato I Morphological and histological analysis of the thoracic duct at the jugulo-subclavian junction in Japanese cadavers Clin Anat 1997 10 3 163 172 10.1002/(SICI)1098-2353(1997)10:3<163::aid-ca2>3.0.CO;2-V Shimada K, Sato I. Morphological and histological analysis of the thoracic duct at the jugulo-subclavian junction in Japanese cadavers[J]. Clin Anat, 1997, 10(3): 163-172. DOI:10.1002/(SICI)1098-2353(1997)10:3<163::aid-ca2>3.0.CO;2-V

周福有胡祎马金山牛奶及脂肪乳剂标记胸导管预防食管癌切除术后乳糜胸中华外科杂志 1999 37 3 35 http://www.cnki.com.cn/Article/CJFDTOTAL-ZHWK903.017.htm 周福有, 胡祎, 马金山, 等. 牛奶及脂肪乳剂标记胸导管预防食管癌切除术后乳糜胸[J]. 中华外科杂志, 1999,37(3): 35.

魏涛张国勇张明超声刀颈淋巴结清扫术后乳糜瘘中国普外基础与临床杂志 2011 18 4 411 413 http://www.cnki.com.cn/Article/CJFDTOTAL-ZPWL201104016.htm 魏涛, 张国勇, 张明, 等. 超声刀颈淋巴结清扫术后乳糜瘘[J]. 中国普外基础与临床杂志, 2011,18(4): 411-413.

储康宁刘业海赵益颈清扫乳糜漏的术中预防中国耳鼻咽喉头颈外科 2012 19 4 169 171 10.16066/j.1672-7002.2012.04.003 储康宁, 刘业海, 赵益, 等.颈清扫乳糜漏的术中预防[J]. 中国耳鼻咽喉头颈外科, 2012,19(4): 169-171.DOI:10.16066/j.1672-7002.2012.04.003

Yetisir F Yürekli B Salman A E The Impact of Harmonic Scalpel on Complications after Neck Dissection in Papillary Thyroid Carcinoma: A Prospective Randomized Study Journal of Thyroid Disorders & Therapy 2012 1 4 10.4172/2167-7948.1000117 Yetisir F, Yürekli B, Salman A E, et al.The Impact of Harmonic Scalpel on Complications after Neck Dissection in Papillary Thyroid Carcinoma: A Prospective Randomized Study [J].Journal of Thyroid Disorders & Therapy, 2012, 1(4). DOI:10. 4172 /2167-7948. 1000117

吴高松黄丽丽涂顺桂颈部手术后乳糜漏的保守治疗中华耳鼻咽喉头颈外科杂志 2009 44 5 404 406 10.3760/cma.j.issn.1673-0860.2009.05.014 吴高松, 黄丽丽, 涂顺桂, 等. 颈部手术后乳糜漏的保守治疗[J]. 中华耳鼻咽喉头颈外科杂志, 2009, 44(5): 404-406. DOI:10.3760/cma.j.issn.1673-0860.2009.05.014

Lorenz K Abuazab M Sekulla C Management of lymph fistulas in thyroid surgery Langenbecks Arch Surg 2010 395 7 911 917 10.1007/s00423-010-0686-2 Lorenz K, Abuazab M, Sekulla C, et al. Management of lymph fistulas in thyroid surgery[J]. Langenbecks Arch Surg, 2010, 395(7): 911-917. DOI:10.1007/s00423-010-0686-2

McCray S Parrish C R Nutritional management of chyle leaks: An update Practical Gastroenterology 2011 35 4 12 32 McCray S, Parrish C R. Nutritional management of chyle leaks: An update[J]. Practical Gastroenterology, 2011, 35(4): 12-32.

Prabhu S Thomas S Octreotide for conservative management of intractable high output post operativechylous fistula: a case report J Maxillofac Oral Surg 2015 14 Suppl 1 21 24 10.1007/s12663-011-0269-y Prabhu S, Thomas S. Octreotide for conservative management of intractable high output post operativechylous fistula: a case report[J]. J Maxillofac Oral Surg, 2015,14(Suppl 1): 21-24. DOI:10.1007/s12663-011-0269-y

Wei T Liu F Li Z Novel Management of Intractable Cervical Chylous Fistula with Local Application of Pseudomonas aeruginosa Injection Otolaryngol Head Neck Surg 2015 153 4 561 565 10.1177/0194599815584917 Wei T, Liu F, Li Z, et al. Novel Management of Intractable Cervical Chylous Fistula with Local Application of Pseudomonas aeruginosa Injection[J]. Otolaryngol Head Neck Surg, 2015, 153(4): 561-565. DOI:10.1177/0194599815584917

程小菊于跃盛湲 50%葡萄糖注射液治疗颈淋巴结清扫术后颈淋巴漏1例临床合理用药杂志 2013 6 16 58 http://www.cnki.com.cn/Article/CJFDTOTAL-PLHY201316049.htm 程小菊, 于跃, 盛湲. 50%葡萄糖注射液治疗颈淋巴结清扫术后颈淋巴漏1例[J]. 临床合理用药杂志, 2013, 6(16): 58.

冯燮林安伟德彭俊平颈部术后乳糜漏的处理中华普通外科杂志 2008 23 9 725 http://www.cnki.com.cn/Article/CJFDTOTAL-ZGYI201210019.htm 冯燮林, 安伟德, 彭俊平. 颈部术后乳糜漏的处理[J]. 中华普通外科杂志, 2008, 23(9): 725.

李真华葛家华汤喜颈淋巴结清扫术后乳糜漏 21 例分析重庆医学 2015 44 14 1904 1905 http://www.cnki.com.cn/Article/CJFDTOTAL-CQYX201514012.htm 李真华, 葛家华, 汤喜, 等. 颈淋巴结清扫术后乳糜漏 21 例分析[J]. 重庆医学, 2015, 44(14): 1904-1905.

刘建平陈涛汪洋甲状腺癌颈清扫术后严重乳糜漏的综合治疗 (附 5 例报告) 岭南现代临床外科 2010 10 5 351 352,357 10.3969/j.issn.1009-976X.2010.05.012 刘建平, 陈涛, 汪洋. 甲状腺癌颈清扫术后严重乳糜漏的综合治疗 (附 5 例报告)[J]. 岭南现代临床外科, 2010 , 10(5): 351-352,357. DOI:10.3969/j.issn.1009-976X.2010.05.012

张建伟宋一丁王军甲状腺癌颈清扫术后乳糜漏的预防及处理甘肃医药 2015 34 8 593 595 10.15975/j.cnki.gsyy.2015.08.015 张建伟, 宋一丁, 王军. 甲状腺癌颈清扫术后乳糜漏的预防及处理[J]. 甘肃医药, 2015, 34(8): 593-595. DOI:10.15975/j.cnki.gsyy.2015.08.015

Takase S Tsukahara K Osaka Y Usefulness of thoracic duct clipping in thoracoscopic surgery for chylous fistula occurring after neck dissection International Cancer Conference Journal 2014 3 3 158 160 10.1007/s13691-013-0137-3 Takase S, Tsukahara K, Osaka Y, et al. Usefulness of thoracic duct clipping in thoracoscopic surgery for chylous fistula occurring after neck dissection[J]. International Cancer Conference Journal, 2014, 3(3): 158-160. DOI:10.1007/s13691-013-0137-3

Abdel-Galil K Milton R McCaul J High output chyle leak after neck surgery: the role of video-assisted thoracoscopic surgery Br J Oral Maxillofac Surg 2009 47 6 478 480 10.1016/j.bjoms.2009.04.030 Abdel-Galil K, Milton R, McCaul J. High output chyle leak after neck surgery: the role of video-assisted thoracoscopic surgery[J]. Br J Oral Maxillofac Surg, 2009, 47(6): 478-480. DOI:10.1016/j.bjoms.2009.04.030

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