选择性结扎胸导管在预防食管癌术后乳糜胸中的应用

目的:探讨选择性胸导管结扎在食管癌切除术中预防术后乳糜胸的作用.方法:将458例食管癌手术切除术病例分为3组.A组153例,术中均不结扎胸导管;B组147例,术中常规预防性结扎胸导管;C组为选择性结扎胸导管组共158例,术中结扎胸导管98例、未结扎60例.结果:术后发生乳糜胸A组8例(5.2%),B组和C组均为0例(0%);B组和C组相比较无统计学差异(P＞0.05),B组和C组与A组比较均有统计学差异(P＜0.05).结论:常规预防性和选择性结扎胸导管均可显著地降低食管癌术后乳糜胸的发生率;在食管癌切除术中,选择性结扎胸导管可预防术后乳糜胸发生.

Application of Ligating Thoracic Duct in the Prevention of Postoperative Chylothorax in Esophageal Carcinoma

Objective:To investigate the effect of ligating thoracic duct in esophageal carcinosectomy to lower the occurrence of postoperative chylothorax in carcinoma of esophagus.Methods:458 cases adopted esophageal carcinosectomy from Jan.2000 to Jan.2005 in our hospital were randomly divided into three groups.Group A consisted of 153 cases without ligating thoracic duct during operation.Group B contained 147 cases with routine prevention of ligating thoracic duct.Group C included 158 cases with selective prevention of ligating thoracic duct.Results:Chylothorax appeared in eight cases of Group A(5.2%),0 cases of Group B and C(0%).There was not statistical difference between Group B and C(P>0.05).The incidence of chylothorax in Group A was higher than those in Group B and C(P<0.05).Conclusions:Selective ligation of thoracic duct and routine prevention of ligating thoracic duct could remarkably lower the incidence of postoperative chylothorax in carcinoma of esophagus.Selective ligation of thoracic duct can prevent the occurrence of postoperative chylothorax.