■乳糜胸是肺部手术后很少遇到的并发症。然而,由于肺部手术的广泛实践,术后并发症不可避免。乳糜胸显著影响患者的出院和康复。本研究调查了我们中心术后乳糜胸的危险因素,并分析了各种治疗方式和预后结果。
■对2018年1月至2021年8月期间进行的所有符合纳入标准的术后肺切除术进行回顾性分析。纳入标准涵盖因肺部疾病而接受各种胸外科手术的患者,而排除标准包括与肺肿瘤无关的手术的术后转诊。
■5,706例肺部手术患者中有42例发生术后乳糜胸。通过单因素和多因素分析对乳糜胸和对照组的一般信息和疾病相关数据进行分析。多因素分析显示术前血清白蛋白[比值比(OR)=0.86,95%置信区间(CI):0.81~0.91,P<0.001]。术前γ-谷氨酰转移酶水平(对数变换后,OR=1.01,95%CI:1.00-1.01,P=0.01),鳞状细胞癌(OR=2.77,95%CI:1.37-5.6,P=0.008),右纵隔淋巴结清扫(OR=3.15,95%CI:1.62~6.14,P<0.001)是术后乳糜胸的独立危险因素。术后乳糜胸42例,26例患者通过保守治疗得到改善,6例患者经化学胸膜固定术得到改善。8例乳糜胸术后患者行胸腔镜胸导管结扎术。3例患者出现严重的术后并发症:1例在长时间治疗后出院,而其余两人则在医疗建议下死亡或出院。
■肺部手术后乳糜胸的发生率与术中创伤及围手术期患者营养状况密切相关。大多数乳糜胸患者通过保守措施缓解,生长抑素给药,和化学胸膜固定术.然而,大量的乳糜胸术后需要手术干预,涉及胸导管结扎或药物胸膜固定术。
UNASSIGNED: Chylothorax is a seldom encountered complication following lung surgery. However, due to the widespread practice of lung surgery, postoperative complications have inevitably arisen. Chylothorax significantly affects a patient\'s discharge and recovery. This study investigates the risk factors for postoperative chylothorax at our center and analyzes various treatment modalities and prognostic outcomes.
UNASSIGNED: A retrospective analysis was conducted on all postoperative lung resections performed between January 2018 to August 2021 that met the inclusion criteria. Inclusion criteria covered patients undergoing various thoracic surgeries for lung conditions, while exclusion criteria included postoperative referrals for surgeries unrelated to lung tumors.
UNASSIGNED: Postoperative chylothorax occurred in 42 of 5,706 patients after lung surgery. General information and disease-related data of the chylothorax and control group were analyzed by univariate and multivariate analyses. Multivariate analysis showed that serum albumin before surgery [odds ratio (OR) =0.86, 95% confidence interval (CI): 0.81-0.91, P<0.001], γ-glutamyl transferase level before surgery (after logarithmic transformation, OR =1.01, 95% CI: 1.00-1.01, P=0.01), squamous cell carcinoma (OR =2.77, 95% CI: 1.37-5.6, P=0.008), right mediastinal lymph node dissection (OR =3.15, 95% CI: 1.62-6.14, P<0.001) were independent risk factors for postoperative chylothorax. Among the 42 cases of postoperative chylothorax, 26 patients were improved with conservative treatments, and 6 patients were improved with chemical pleurodesis. Eight patients with postoperative chylothorax underwent thoracoscopic thoracic duct ligation. Three patients experienced severe postoperative complications: one was discharged after prolonged treatment, while the remaining two either succumbed or were discharged against medical advice.
UNASSIGNED: The incidence of chylothorax after lung surgery closely correlates with the intraoperative trauma and nutritional status of patients during the perioperative period. The majority of patients with postoperative chylothorax experienced relief through conservative measures, somatostatin administration, and chemical pleurodesis. Nevertheless, substantial postoperative chylothorax necessitated surgical intervention, involving thoracic duct ligation or drug pleurodesis.