Department of Surgical Oncology, Gifu university, graduate school of Medicine, 1-1 Yanagido, Gifu city, 501-1194, Japan.
Department of Radiology, Gifu University Hospital, Gifu, Japan.
Clin J Gastroenterol. 2021 Aug;14(4):969-974. doi: 10.1007/s12328-021-01429-z. Epub 2021 May 11.
Chylothorax after esophagectomy is a serious complication that is associated with major morbidity due to dehydration and malnutrition. Reoperation with ligation of the thoracic duct is considered for patients with high-output chyle leaks that have failed conservative management. In this report, we present the treatment options for chylothorax after esophagectomy: inguinal intranodal lymphangiography and transvenous retrograde thoracic duct embolization. A 74-year-old man with esophageal cancer had been operated with thoracoscopic esophagectomy. Six days after surgery, he presented with high-output chyle leaks. Conservative treatment did not result in a significant improvement. Inguinal intranodal lymphangiography and transvenous retrograde thoracic duct embolization were performed 13 days after surgery and were technically and clinically successful. Inguinal intranodal lymphangiography and transvenous retrograde thoracic duct embolization are an effective treatment option, especially for patients after esophagectomy with reconstruction performed via the posterior mediastinal route, without the potential for damage the gastric tube and omentum.
乳糜胸是食管癌手术后的一种严重并发症，由于脱水和营养不良，可导致严重的发病率。对于保守治疗失败的高流量乳糜漏患者，应考虑再次手术结扎胸导管。在本报告中，我们介绍了食管癌手术后乳糜胸的治疗选择：腹股沟淋巴结内淋巴管造影和经静脉逆行胸导管栓塞。一名 74 岁男性患有食管癌，接受了胸腔镜食管切除术。手术后 6 天，他出现了高流量乳糜漏。保守治疗并未显著改善。手术后 13 天进行了腹股沟淋巴结内淋巴管造影和经静脉逆行胸导管栓塞，技术和临床均成功。腹股沟淋巴结内淋巴管造影和经静脉逆行胸导管栓塞是一种有效的治疗选择，特别是对于通过后纵隔途径进行重建的食管癌手术后患者，没有损伤胃管和大网膜的潜在风险。
