PDF(Pubmed)
Abstract：
To demonstrate intranodal thoracic duct embolization (TDE) for treating chyle leaks following thoracic surgery and the feasibility of applying lower-limb intermittent pneumatic compression devices during TDE.
Between December 2017 and October 2020, 12 consecutive TDEs for post-operative chyle leaks were performed in 11 patients using intranodal lymphangiogram (IL) with an intermittent pneumatic compressive device applied to the lower limb. The procedure\'s duration, technical/clinical success, and complications were retrospectively evaluated.
IL was successful at imaging the thoracic duct in all procedures (100%), and TDE had an intention- to-treat success rate of 92% (11/12). No related complications were observed during follow-up, which took place at a mean of 27 days. The time from the commencement of lymphangiogram until visualization of the thoracic duct was a mean of 21.6 min, and the mean overall procedure time was 87.3 min.
This study supports IL-guided TDE as a safe and effective option to treat post-thoracic surgery chyle leaks. We revealed shorter lymphangiogram times compared with previously published studies, and we postulate that the application of intermittent lower-limb pneumatic compressive devices contributed toward this study\'s results by expediting the return of lymph from the lower limb. This study is the first to illustrate this approach in TDE and advocates for randomized controlled studies to further evaluate the influence of intermittent pneumatic compressive devices on the procedure.
Between December 2017 and October 2020, 12 consecutive TDEs for post-operative chyle leaks were performed in 11 patients using intranodal lymphangiogram (IL) with an intermittent pneumatic compressive device applied to the lower limb. The procedure\'s duration, technical/clinical success, and complications were retrospectively evaluated.
IL was successful at imaging the thoracic duct in all procedures (100%), and TDE had an intention- to-treat success rate of 92% (11/12). No related complications were observed during follow-up, which took place at a mean of 27 days. The time from the commencement of lymphangiogram until visualization of the thoracic duct was a mean of 21.6 min, and the mean overall procedure time was 87.3 min.
This study supports IL-guided TDE as a safe and effective option to treat post-thoracic surgery chyle leaks. We revealed shorter lymphangiogram times compared with previously published studies, and we postulate that the application of intermittent lower-limb pneumatic compressive devices contributed toward this study\'s results by expediting the return of lymph from the lower limb. This study is the first to illustrate this approach in TDE and advocates for randomized controlled studies to further evaluate the influence of intermittent pneumatic compressive devices on the procedure.
摘要：
目的演示胸廓手术后结内胸导管栓塞术（TDE）治疗乳糜漏的可行性，以及在TDE期间应用下肢间歇性充气加压装置的可行性。
在2017年12月至2020年10月之间，使用结内淋巴管图（IL）对11名患者进行了12次连续的术后乳糜渗漏TDE，并在下肢应用了间歇性气动压缩装置。程序的持续时间,技术/临床成功，和并发症进行回顾性评估。
在所有手术中，IL对胸导管成像均成功（100%），TDE的意向治疗成功率为92%(11/12)。随访期间无相关并发症发生,平均发生了27天。从淋巴管图开始到胸导管可视化的时间平均为21.6分钟，平均总手术时间为87.3min.
本研究支持IL引导的TDE作为治疗胸外科术后乳糜漏的安全有效的选择。我们发现与以前发表的研究相比，淋巴管造影时间更短，我们假设间歇性下肢气动压缩装置的应用通过加速下肢淋巴的返回对这项研究的结果做出了贡献。这项研究是第一个在TDE中说明这种方法的研究，并倡导进行随机对照研究，以进一步评估间歇性气动压缩装置对手术的影响。
在2017年12月至2020年10月之间，使用结内淋巴管图（IL）对11名患者进行了12次连续的术后乳糜渗漏TDE，并在下肢应用了间歇性气动压缩装置。程序的持续时间,技术/临床成功，和并发症进行回顾性评估。
在所有手术中，IL对胸导管成像均成功（100%），TDE的意向治疗成功率为92%(11/12)。随访期间无相关并发症发生,平均发生了27天。从淋巴管图开始到胸导管可视化的时间平均为21.6分钟，平均总手术时间为87.3min.
本研究支持IL引导的TDE作为治疗胸外科术后乳糜漏的安全有效的选择。我们发现与以前发表的研究相比，淋巴管造影时间更短，我们假设间歇性下肢气动压缩装置的应用通过加速下肢淋巴的返回对这项研究的结果做出了贡献。这项研究是第一个在TDE中说明这种方法的研究，并倡导进行随机对照研究，以进一步评估间歇性气动压缩装置对手术的影响。
