https://scholars.lib.ntu.edu.tw/handle/123456789/476292
標題: | Spontaneous healing of retroperitoneal chylous leakage following anterior lumbar spinal surgery: A case report and literature review | 作者: | Su I.-C. CHANG-MU CHEN |
公開日期: | 2007 | 卷: | 16 | 期: | SUPPL. 3 | 起(迄)頁: | S332-S337 | 來源出版物: | European Spine Journal | 摘要: | Cisterna chyli is prone to injury in any retroperitoneal surgery. However, retroperitoneal chylous leakage is a rare complication after anterior spinal surgery. To the best of our knowledge, only ten cases have been reported in the English literature. We present a case of a 49-year-old man who had lumbar metastasis and associated radiculopathy. He had transient retroperitoneal chylous leakage after anterior tumor decompression, interbody bony fusion, and instrumental fixation from L2 to L4. The leakage stopped spontaneously after we temporarily clamped the drain tube. Intraperitoneal ascites accumulation developed thereafter due to nutritional loss and impaired hepatic reserves. We gathered ten reported cases of chylous leak after anterior thoracolumbar or lumbar spinal surgery, and categorized all these cases into two groups, depending on the integrity of diaphragm. Six patients received anterior spinal surgery without diaphragm splitting. Postoperative chylous leak stopped after conservative treatment. Another five cases received diaphragm splitting in the interim of anterior spinal surgery. Chylous leakage stopped spontaneously in four patients. The remaining one had a chylothorax secondary to postop chyloretroperitoneum. It was resolved only after surgical intervention. In view of these cases, all the chylous leakage could be spontaneously closed without complications, except for one who had a secondary chylothorax and required thoracic duct ligation and chemopleurodesis. We conclude that intraoperative diaphragm splitting or incision does not increase the risk of secondary chylothorax if it was closed tightly at the end of the surgery and the chest tube drainage properly done. ? 2007 Springer-Verlag. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-37349054096&doi=10.1007%2fs00586-007-0305-2&partnerID=40&md5=e67b516b5103e27c828957aee91f1196 https://scholars.lib.ntu.edu.tw/handle/123456789/476292 |
ISSN: | 0940-6719 | DOI: | 10.1007/s00586-007-0305-2 | SDG/關鍵字: | adult; article; case report; chyle; chylothorax; diaphragm; human; lumbar spine; male; priority journal; radiculopathy; retroperitoneal disease; spine fusion; spine metastasis; spine stabilization; spine surgery; thoracolumbar spine; Chylous Ascites; Decompression, Surgical; Diaphragm; Humans; Internal Fixators; Lumbar Vertebrae; Male; Middle Aged; Neurosurgical Procedures; Postoperative Complications; Radiculopathy; Retroperitoneal Space; Spinal Fusion; Spinal Neoplasms; Suction; Thoracic Duct; Wound Healing |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。