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Published in: General Thoracic and Cardiovascular Surgery 11/2020

01-11-2020 | Esophageal Cancer | Case Report

Postoperative chylothorax with a duplicated left-sided thoracic duct: a case report and review of the literature

Authors: Ryoma Haneda, Eisuke Booka, Kenjiro Ishii, Hirotoshi Kikuchi, Yoshihiro Hiramatsu, Kinji Kamiya, Takeshi Aramaki, Hiroya Takeuchi, Yasuhiro Tsubosa

Published in: General Thoracic and Cardiovascular Surgery | Issue 11/2020

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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.
Literature
1.
go back to reference Japanese esophageal society. Japanese classification of esophageal cancer, 11th edition: part I. Esophagus. 2017;14:1–36.CrossRef Japanese esophageal society. Japanese classification of esophageal cancer, 11th edition: part I. Esophagus. 2017;14:1–36.CrossRef
2.
go back to reference 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.CrossRef 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.CrossRef
3.
go back to reference Der AB. Ductus thoracicus der Japaner. In: Kihara T, editor. Das lymphagefasssystem der Japaner. Tokyo: Kenkyusha; 1953. p. 1–83. Der AB. Ductus thoracicus der Japaner. In: Kihara T, editor. Das lymphagefasssystem der Japaner. Tokyo: Kenkyusha; 1953. p. 1–83.
4.
go back to reference 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.CrossRef 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.CrossRef
5.
go back to reference Marts BC, Naunheim KS, Fiore AC, Pennington DG. Conservative versus surgical management of chylothorax. Am J Surg. 1992;164:532–5.CrossRef Marts BC, Naunheim KS, Fiore AC, Pennington DG. Conservative versus surgical management of chylothorax. Am J Surg. 1992;164:532–5.CrossRef
6.
go back to reference Orringer MB, Bluett M, Deeb M. Aggressive treatment of chylothorax complicating transhiatal esophagectomy without thoracotomy. Surgery. 1988;104:720–6.PubMed Orringer MB, Bluett M, Deeb M. Aggressive treatment of chylothorax complicating transhiatal esophagectomy without thoracotomy. Surgery. 1988;104:720–6.PubMed
7.
go back to reference 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.CrossRef 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.CrossRef
8.
go back to reference 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.CrossRef 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.CrossRef
9.
go back to reference 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.CrossRef 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.CrossRef
Metadata
Title
Postoperative chylothorax with a duplicated left-sided thoracic duct: a case report and review of the literature
Authors
Ryoma Haneda
Eisuke Booka
Kenjiro Ishii
Hirotoshi Kikuchi
Yoshihiro Hiramatsu
Kinji Kamiya
Takeshi Aramaki
Hiroya Takeuchi
Yasuhiro Tsubosa
Publication date
01-11-2020
Publisher
Springer Singapore
Published in
General Thoracic and Cardiovascular Surgery / Issue 11/2020
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-020-01374-7

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