胸导管阻断在食管癌手术中的应用

目的探索使用安全、有效的胸导管阻断方法，以减少或避免食管癌手术后乳糜胸的发生．方法在熟悉胸导管解剖结构基础上，低位明视结扎之，近期使用染色技术使胸导管更易辨认，确定其形态并确定无遗漏后结扎．术后观察效果．结果文献报告食管癌术后乳糜胸的发生率为０．４～２．６％，本组２８０例术后无１例发生乳糜胸．结论食管癌手术中胸导管阻断应低位、明视、准确结扎，使用染色技术更易辨认．凡主动脉弓以上食管胃吻合者，均应便用胸导管阻断技术以进免术后乳糜胸的发生。

Application of ligating thoracic duct in operation of esophageal carcinoma

Objective To research a safe, and effective method of ligating thoracic duct to prevent the occurrence of chylothorax, a serious complication after the operation. Method On the basis of knowing the anatomic structure of thoracic duct well, ligature the thoracic duct at low position under direct vision. The recently using of staining technic that makes it easy to discriminate, determine its pattern and ligature it accurately,the postoperative effect is studied. Result The occurrence of chylothorax is 0. 4￣ 2.6% after the operation of esophageal carcinoma according to the report of literature. None in the 280 cases in this study developed postoperative chylothorax.Conclusion The ligating thoracic duct in operation of esophageal carcinoma ought to be at low position, under direct vision and ligatured exactly, using the staining technic makes it easy to discriminate in order to prevent the occurrence of postoperative chylothorax. Ligation of thoracic duct should be adapted to all the patients with esophagogastrostomy above the aortic arch.