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Nutritional Outcomes of Thoracic Duct Resection for Radical Esophagectomy by Assessing Body Composition Changes in One Year: A Single-Center Retrospective Study

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Thoracic duct (TD) resection is performed when the tumor or a metastatic lymph node directly invades the TD, and is sometimes indicated for radical lymphadenectomy during esophagectomy in esophageal cancer patients. However, the effect of TD resection on nutritional status has not been established.

Patients and Methods

In total, 174 consecutive patients from October 2015 to March 2019 who underwent radical esophagectomy for esophageal cancer in Toranomon Hospital were classified into thoracic duct preserved group (n = 51) and TD-resected (TD-R) group (n = 123). We compared laboratory data, body composition data from bioelectrical impedance analysis measured preoperatively and at 1 and 12 months after surgery, and postoperative complications between the two groups.

Results

Clinical stage was significantly more advanced in the TD-R group. Total body weight, body mass index, and fat mass continuously decreased in the two groups over 12 months after surgery, and the decreases were statistically greater in the TD-R group at 12 months after surgery. Skeletal muscle mass and fat-free mass decreased over 1 month after surgery and stayed in a reduced state until 12 months after surgery without statistically significant differences between the two groups. TD resection did not increase incidence of postoperative complications (Clavien–Dindo classification ≥ grade III), but TD resection increased incidence of chylothorax.

Conclusions

Our results suggest that loss of body fat mass, which was a main contributor to body weight loss, was accelerated in the TD-R group, but TD resection does not deteriorate loss of muscle mass at 12 months after surgery.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Toranomon Hospital, Okinaka Memorial Institute for Medical Research, Tokyo, Japan

    Kentoku Fujisawa MD, Yu Ohkura MD, PhD, Masaki Ueno MD, PhD, Akikazu Yago MD, Hayato Shimoyama MD, PhD & Harushi Udagawa MD, PhD

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  1. Kentoku Fujisawa MD
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  2. Yu Ohkura MD, PhD
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  3. Masaki Ueno MD, PhD
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  4. Akikazu Yago MD
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  5. Hayato Shimoyama MD, PhD
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  6. Harushi Udagawa MD, PhD
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Contributions

KF, YO, and MU designed the study, wrote the manuscript, revised it critically for important intellectual content, and gave final approval for the content; KF, YO, MU, and HU created study materials or recruited patients.

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Correspondence to Kentoku Fujisawa MD.

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Fujisawa, K., Ohkura, Y., Ueno, M. et al. Nutritional Outcomes of Thoracic Duct Resection for Radical Esophagectomy by Assessing Body Composition Changes in One Year: A Single-Center Retrospective Study. Ann Surg Oncol 28, 8414–8425 (2021). https://doi.org/10.1245/s10434-021-10222-8

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  • DOI: https://doi.org/10.1245/s10434-021-10222-8

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