摘要: Chylous leaks, such as chylothorax and chylopericardium, are uncommon effusions resulting from the leakage of intestinal lymphatic fluid thoracic duct (TD) its tributaries, or ducts. The cause can be either traumatic (thoracic surgery) nontraumatic (idiopathic, malignancy). Treatment has traditionally consisted dietary modification (nonfat diet) and/or surgery (TD ligation, pleurodesis). Thoracic embolization (TDE) become a viable treatment alternative due to it high success rate minimal complications. In this article, authors describe etiologies chylothorax, patient population, outcomes, long-term follow-up TDE patients. Relevant anatomy physiology reviewed, with special attention paid formation by tributaries at cisterna chyli (CC). technique is outlined, including bilateral pedal lymphangiography, TD cannulation, embolic agents used for procedure.
thieme-connect.de 参考文章(34)
M. B. Orringer, M. Bluett, G. M. Deeb, Aggressive treatment of chylothorax complicating transhiatal esophagectomy without thoracotomy. Surgery. ,vol. 104, pp. 720- 726 ,(1988)
F I I Arthur Dalley, Anne M.R. Agur, Grant's Atlas of Anatomy ,(1943)
Kevin G. Burnand, Norman Browse, Peter Mortimer, Diseases of the Lymphatics ,(2003)
D. Dougenis, E. W. J. Cameron, W. S. Walker, P. R. Walbaum, Management of chylothorax complicating extensive esophageal resection. Surgery gynecology & obstetrics. ,vol. 174, pp. 501- 506 ,(1992)
Constantin Cope, Diagnosis and Treatment of Postoperative Chyle Leakage via Percutaneous Transabdominal Catheterization of the Cisterna Chyli: A Preliminary Study Journal of Vascular and Interventional Radiology. ,vol. 9, pp. 727- 734 ,(1998) , 10.1016/S1051-0443(98)70382-3
Constantin Cope, Larry R. Kaiser, Management of Unremitting Chylothorax by Percutaneous Embolization and Blockage of Retroperitoneal Lymphatic Vessels in 42 Patients Journal of Vascular and Interventional Radiology. ,vol. 13, pp. 1139- 1148 ,(2002) , 10.1016/S1051-0443(07)61956-3
Christoph A. Binkert, E. Kent Yucel, Brian D. Davison, David J. Sugarbaker, Richard A. Baum, Percutaneous Treatment of High-Output Chylothorax with Embolization or Needle Disruption Technique Journal of Vascular and Interventional Radiology. ,vol. 16, pp. 1257- 1262 ,(2005) , 10.1097/01.RVI.0000167869.36093.43
Maxim Itkin, John C. Kucharczuk, Andrew Kwak, Scott O. Trerotola, Larry R. Kaiser, Nonoperative thoracic duct embolization for traumatic thoracic duct leak: Experience in 109 patients The Journal of Thoracic and Cardiovascular Surgery. ,vol. 139, pp. 584- 590 ,(2010) , 10.1016/J.JTCVS.2009.11.025
AN Plotnik, PT Foley, J Koukounaras, SM Lyon, How I do it: Lymphangiography. Journal of Medical Imaging and Radiation Oncology. ,vol. 54, pp. 43- 46 ,(2010) , 10.1111/J.1754-9485.2010.02135.X
Itsuko Okuda, Harushi Udagawa, Junji Takahashi, Hiromi Yamase, Tadasu Kohno, Yasuo Nakajima, Magnetic resonance-thoracic ductography: imaging aid for thoracic surgery and thoracic duct depiction based on embryological considerations General Thoracic and Cardiovascular Surgery. ,vol. 57, pp. 640- 646 ,(2009) , 10.1007/S11748-009-0483-4