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Chylothorax after Video-Assisted Thoracoscopic Anterior Release for Severe Adolescent Idiopathic Scoliosis

胸腔內視鏡手術矯正嚴重青少年原因不明型脊椎側彎術後之乳糜胸

摘要


在經胸腔內視鏡手術矯正嚴重青少年原因不明型脊椎側彎,術後併發乳糜胸是非常稀少的。本文將簡述一名十三歲女性病人,在診斷為青少年原因不明型脊椎側彎後,接受胸腔內視鏡矯正手術,術後併發乳糜胸之治療過程。我們初始以飲食控制及藥物治療為主,然而大量乳糜滲漏的情況沒有改善。於是我們選擇以手術治療。在接受胸腔內視鏡胸管結紮手術後,大量淋巴液滲漏依舊,最後病人接受開胸探查,發現於右側橫膈上胸壁淋巴液到處滲漏。我們以組織凝膠行肋膜沾黏術後,終於止住滲漏。我們將陳述這個病例並且討論其治療方式及文獻回顧。

並列摘要


Chylothorax has been reported rarely in patients with anterior release of severe adolescent idiopathic scoliosis (AIS) using video-assisted thoracoscopic surgery (VATS). A young girl was diagnosed with chylothorax after anterior release of the spinal deformity. After medical treatment, massive chyle leakage was still noted, and 2 surgical interventions were performed to treat the complicated condition. Anatomic variation of the thoracic duct as a network was highly suspected, and tissue glue was applied for adhesion. We present this case with a discussion of treatment for complicated chylothorax after VATS correction of severe AIS.

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