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Prevention of postoperative chylothorax with thoracic duct ligation during video-assisted thoracoscopic esophagectomy for cancer

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Abstract

Background

Minimally invasive esophagectomy (MIE) is a feasible technique that has been shown to be safe for the treatment of esophageal cancer. Chylothorax remains a challenging and potentially life-threatening postoperative complication of MIE. In this retrospective series, we evaluated the results of preventive intraoperative thoracic duct ligation in patients who underwent video-assisted thoracoscopic esophagectomy for cancer.

Methods

From May 2009 to June 2010, 70 video-assisted thoracoscopic esophagectomies for cancer of the esophagus (group A) were performed without prophylactic thoracic duct ligation. Since June 2010, 65 patients (group B) with esophageal cancer underwent video-assisted thoracoscopic esophagectomy with routine ligation of the thoracic duct during the operation.

Results

No intraoperative or postoperative complications directly related to thoracic duct ligation were recorded. Postoperative chylothorax occurred in seven patients in group A and in one patient in group B (P = 0.0375).

Conclusions

The results of this study suggest that thoracic duct ligation during video-assisted thoracoscopic esophagectomy for cancer is an effective and safe method for prevention of postoperative chylothorax.

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Disclosures

Wei Guo, Yun-Ping Zhao, Yao-Guang Jiang, Hui-Jun Niu, Xue-Hai Liu, Zheng Ma, and Ru-Wen Wang have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Changjiang Route 10#, Daping, Chongqing, 400042, The People’s Republic of China

    Wei Guo, Yun-Ping Zhao, Yao-Guang Jiang, Hui-Jun Niu, Xue-Hai Liu, Zheng Ma & Ru-Wen Wang

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  1. Wei Guo
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  2. Yun-Ping Zhao
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  3. Yao-Guang Jiang
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  7. Ru-Wen Wang
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Correspondence to Yao-Guang Jiang.

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Guo, W., Zhao, YP., Jiang, YG. et al. Prevention of postoperative chylothorax with thoracic duct ligation during video-assisted thoracoscopic esophagectomy for cancer. Surg Endosc 26, 1332–1336 (2012). https://doi.org/10.1007/s00464-011-2032-3

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  • DOI: https://doi.org/10.1007/s00464-011-2032-3

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