Indications, techniques, and clinical outcomes of thoracic duct interventions in patients: a forgotten literature?
作者： Hsiang-Wei Wang , Alistair Brian James Escott , Kian Luke Phang , Maxim S. Petrov , Anthony Ronald John Phillips
DOI: 10.1016/J.JSS.2016.04.050
关键词:
摘要: Abstract Background The evolution of the “gut-lymph concept” has promoted thoracic duct (TD) lymph drainage as a possible treatment to reduce systemic inflammation and end-organ dysfunction in acute illness. aim was review published experience interventions (TDIs) aimed at improving clinical outcomes. Methods A search three databases (MEDLINE, EMBASE, EMBASE CLASSIC) over last 60 y. indications for intervention, technique, outcomes were reviewed. Results There wide range TDI. These included reducing rejection after transplantation, treating inflammatory diseases, chronic failure liver, kidney, heart. techniques TD cannulation lymphovenuous fistula. variable often equivocal, this appears reflect poor design quality. is equipoise regarding therapeutic role (TD pancreatitis, probably other diseases. Conclusions Until well-designed trials are undertaken, benefits TDIs will remain promising, but uncertain.
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