Abstract：
For evaluation of a novel surgical procedure for the treatment of chylous ascites. Chylous ascites is a debilitating condition associated with high morbidity and mortality rates. At least one-third of patients are refractory to medical therapy and may warrant further treatment. Traditional methods involving ligation of lymphatic fistulas or small bowel resection do not address the basic pathophysiologic mechanism of the underlying obstruction, and identification of chyloperitoneal fistulas may be challenging.
A novel flap based on deep inferior epigastric vessels with its surrounding lymphatic fatty tissue was designed in this study and transferred into abdominal cavity, with anastomosis to the fourth jejunal vessels. Three consecutive cases with chylous ascites treated by this vascularized lymphatic cable transfer were retrospectively reviewed.
All three patients recovered from chylous ascites after the lymphatic cable transfer and tolerated regular diet well, with follow-up of 3 years at least.
Lymphatic cable flap based on the deep inferior epigastric vessels could be a potential option for treatment of intractable chylous ascites, with safe and successful long-term outcomes in three consecutive patients. The proposed functional mechanism of the flap is bypass of the obstructed intra-abdominal lymphatics to an extraperitoneal route as well as local lymphangiogenesis.
A novel flap based on deep inferior epigastric vessels with its surrounding lymphatic fatty tissue was designed in this study and transferred into abdominal cavity, with anastomosis to the fourth jejunal vessels. Three consecutive cases with chylous ascites treated by this vascularized lymphatic cable transfer were retrospectively reviewed.
All three patients recovered from chylous ascites after the lymphatic cable transfer and tolerated regular diet well, with follow-up of 3 years at least.
Lymphatic cable flap based on the deep inferior epigastric vessels could be a potential option for treatment of intractable chylous ascites, with safe and successful long-term outcomes in three consecutive patients. The proposed functional mechanism of the flap is bypass of the obstructed intra-abdominal lymphatics to an extraperitoneal route as well as local lymphangiogenesis.
摘要：
用于评估用于治疗乳糜腹水的新型外科手术。乳糜腹水是一种与高发病率和死亡率相关的衰弱状况。至少三分之一的患者难以接受药物治疗，可能需要进一步治疗。涉及淋巴瘘结扎或小肠切除术的传统方法未解决潜在梗阻的基本病理生理机制。乳糜腹膜瘘的识别可能具有挑战性。
在这项研究中，设计了一种基于深腹壁下血管及其周围淋巴脂肪组织的新型皮瓣，并将其转移到腹腔中。与第四根空肠血管吻合.回顾性回顾了通过这种血管化淋巴管转移治疗的三例乳糜腹水。
所有3名患者在淋巴电缆转移后从乳糜腹水中恢复，并能很好地耐受常规饮食，至少随访3年。
基于深腹壁下血管的淋巴索皮瓣可能是治疗顽固性乳糜性腹水的潜在选择。在连续3例患者中获得安全和成功的长期结局。皮瓣的拟议功能机制是将阻塞的腹内淋巴管绕过腹膜外途径以及局部淋巴管生成。
在这项研究中，设计了一种基于深腹壁下血管及其周围淋巴脂肪组织的新型皮瓣，并将其转移到腹腔中。与第四根空肠血管吻合.回顾性回顾了通过这种血管化淋巴管转移治疗的三例乳糜腹水。
所有3名患者在淋巴电缆转移后从乳糜腹水中恢复，并能很好地耐受常规饮食，至少随访3年。
基于深腹壁下血管的淋巴索皮瓣可能是治疗顽固性乳糜性腹水的潜在选择。在连续3例患者中获得安全和成功的长期结局。皮瓣的拟议功能机制是将阻塞的腹内淋巴管绕过腹膜外途径以及局部淋巴管生成。
