Abstract
Postoperative chylothorax is a potentially lethal complication after esophagectomy. A 53-year-old woman underwent subtotal esophagectomy. The thoracic duct was resected due to swollen lymph nodes. Postoperative chylothorax was diagnosed but conservative treatment was ineffective. Lipiodol lymphangiography revealed leakage from a duplicated left-sided thoracic duct. Left-sided video-assisted thoracoscopic ligation of the left-sided thoracic duct was performed. Because anatomical variations in the thoracic duct contribute to refractory chylothorax, lymphangiography is useful in detecting the position of thoracic duct injury as well as any duct anomalies. Based on lymphangiography, left-sided video-assisted thoracoscopic surgery could be considered in case of left-sided thoracic duct injury.
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References
Japanese esophageal society. Japanese classification of esophageal cancer, 11th edition: part I. Esophagus. 2017;14:1–36.
Takeuchi H, Miyata H, Ozawa S, Udagawa H, Osugi H, Matsubara H, et al. Comparison of short-term outcomes between open and minimally invasive esophagectomy for esophageal cancer using a nationwide database in Japan. Ann Surg Oncol. 2017;24:1821–7.
Der AB. Ductus thoracicus der Japaner. In: Kihara T, editor. Das lymphagefasssystem der Japaner. Tokyo: Kenkyusha; 1953. p. 1–83.
Matsumoto T, Yamagami T, Kato T, Hirota T, Yoshimatsu R, Masunami T, et al. The effectiveness of lymphangiography as a treatment method for various chyle leakages. Br J Radiol. 2009;82:286–90.
Marts BC, Naunheim KS, Fiore AC, Pennington DG. Conservative versus surgical management of chylothorax. Am J Surg. 1992;164:532–5.
Orringer MB, Bluett M, Deeb M. Aggressive treatment of chylothorax complicating transhiatal esophagectomy without thoracotomy. Surgery. 1988;104:720–6.
Merigliano S, Molena D, Ruol A, Zaninotto G, Cagol M, Scappin S, et al. Chylothorax complicating esophagectomy for cancer: a plea for early thoracic duct ligation. J Thorac Cardiovasc Surg. 2000;119(3):453–7.
Abe T, Kawai R, Uemura N, Kawakami J, Ito S, Koji K, et al. Chylous leakage from a remaining duplicated left-sided thoracic duct after esophagectomy successfully treated by ligation of the left-sided thoracic duct with left-sided video-assisted thoracoscopic surgery with the patient in the prone position. Asian J Endosc Surg. 2016;9:138–41.
Mine S, Udagawa H, Kinoshita Y, Makuuchi R. Post-esophagectomy chylous leakage from a duplicated left-sided thoracic duct ligated successfully with left-sided video-assisted thoracoscopic surgery. Interact Cardiovasc Thorac Surg. 2008;7:1186–8.
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Haneda, R., Booka, E., Ishii, K. et al. Postoperative chylothorax with a duplicated left-sided thoracic duct: a case report and review of the literature. Gen Thorac Cardiovasc Surg 68, 1350–1353 (2020). https://doi.org/10.1007/s11748-020-01374-7
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DOI: https://doi.org/10.1007/s11748-020-01374-7