UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 乳糜胸症のマネージメントmanagement of chylothorax [show details]
…pleurodesis, thoracic duct embolization or disruption, ligation or repair of the thoracic duct, or combinations of these therapies (typically pleurodesis with TDL) . As examples: Patients who drain lower volumes …
2. 乳糜胸症の病因、臨床像、および診断etiology clinical presentation and diagnosis of chylothorax [show details]
…left subclavian and jugular veins . As the thoracic duct passes through the mediastinum, it also receives nonchylous lymph from tributaries that drain regions of the pulmonary parenchyma and parietal …
3. 分化型甲状腺癌に行う頸部郭清術neck dissection for differentiated thyroid cancer [show details]
… Insertion of a drain should be done selectively if at all, as it will not prevent bleeding or seroma formation . If there is any suspicion of injury to the thoracic duct, a drain should be placed. …
4. Thyroidectomythyroidectomy [show details]
… a closed suction drain can be placed to prevent fluid collection . The drain can be removed safely without concern… prevertebral fascia and carotid sheath. Chyle leaks or fistulas are caused by injury to the thoracic duct. Chyle leak is reported in 1.8 to 8.3 percent of thyroidectomies. Although chyle leak occurs most …
5. 乳糜心膜症およびコレステロール心膜炎chylopericardium and cholesterol pericarditis [show details]
… one end and in the peritoneum at the other to drain the chyle away from the pericardium and into the peritoneal cavity where it can be absorbed . Thoracic duct embolization has been proposed as a simple and …

English Journal

Negative Pressure Wound Therapy (Wound VAC) in the Treatment of Chylous Fistula After Neck Dissection.

Dorneden A, Olson G, Boyd N.
The Annals of otology, rhinology, and laryngology. 2019 Jun;128(6)569-574.
Cervical chylous fistula is an uncommon but potentially severe occurrence associated with neck surgery. Methods for treating this problem have inconsistent efficacy and may result in lengthy hospital stays. Negative pressure wound therapy (NPWT) is a highly effective tool in the management of comple
PMID 30693805
PMID 29083798

Yellow nail syndrome resulting from cardiac mitral valve replacement.

Sarmast H, Takriti A.
Journal of cardiothoracic surgery. 2019 Apr;14(1)72.
Yellow nail syndrome is a rare disease with unknown etiology, Attributed to functional anomalies or disturbance in lymphatic drainage. This condition is characterized by triad of nail discoloration, respiratory or intrathoracic manifestations and lymphedema. Twenty days after mitral valve replacemen
PMID 30971303

Japanese Journal

慢性膵炎に合併した膵管胸腔瘻に対して膵頭十二指腸切除術と瘻孔結紮術を施行した1例

杉田浩章,三井毅,寺田卓郎,俵広樹,奥出輝夫,島田雅也,斎藤健一郎,天谷奨,高嶋吉浩,宗本義則
日本消化器外科学会雑誌 51(3), 214-221, 2018
症例は47歳の男性で，アルコール性の慢性膵炎の急性増悪とそれに伴う十二指腸狭窄に対して当院内科で保存的加療を行い改善した．その後も禁酒を守れず再増悪に対して入院加療を要し，ERCPでは胆管狭窄も認めるようになった．また，左胸腔には膵管胸腔瘻による膵性胸水の貯留も認めるようになり胸腔ドレーン留置による加療を行った．内視鏡的膵管減圧は困難であり，胆管狭窄と膵性胸水の改善を認めなかった …
NAID 130006575820

経静脈的胸管塞栓術により治療した難治性乳び胸の一例

杉村裕志,山崎郁郎,伊藤有祐,叢岳,野守裕明,武士昭彦
日本呼吸器外科学会雑誌 31(1), 122-126, 2017
非術後性乳び胸は病態が複雑で治療に難渋することが多い．腹水を伴う肝硬変に併発した難治性乳び胸を逆行性経静脈的アプローチによる胸管塞栓術で治療した．症例は60歳代の男性．絶食期間と2回の胸膜癒着療法を経ても乳び胸水の流出が続いた．鼡径部穿刺による経リンパ節リンパ管造影法により右胸腔内へのリンパ漏の部位診断を行った後に逆行性静脈アプローチによる胸管塞栓術を行い乳び瘻の速やかな停止を得 …
NAID 130005289958

胸部食道癌切除後の胸腔ドレーン排液量の検討

竹林克士,坪佐恭宏,島田理子,坊岡英祐,新原正大
日本外科系連合学会誌 41(4), 553-558, 2016
【目的】胸部食道切除後の胸腔ドレーン排液量は個々の症例において様々である．今回，われわれは食道癌切除再建後のドレーン排液量とその臨床的意義に関して検討した．【方法】2012年１月から2015年４月に縦隔郭清を伴う胸部食道癌切除症例51例を対象とし，胸腔ドレーン排液量の推移，抜去日，それらに影響する因子を検証した．<p …
NAID 130006026432