Percutaneous embolization of thoracic duct injury post-esophagectomy should be considered initial treatment for chylothorax before proceeding with open re-exploration

Marthaller, Kyle J.; Johnson, Stephen; Pride, Robert M.; Ratzer, Erick R.; Hollis, Harris W.

doi:10.1016/j.amjsurg.2014.05.031

Cited by 27 publications

(7 citation statements)

References 22 publications

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“…Such procedures are commonly conducted by thoracic surgeons and otolaryngologists in addition to spine surgeons. For instance, Marthaller et al describe a series of patients that incurred damage to the thoracic duct following esophagectomy; 21 this manifested through the formation of a chylothorax and/or a high-output chylous fistula. For such cases, the authors advocated for percutaneous embolization of the thoracic duct prior to open re-exploration.…”

Section: Discussionmentioning

confidence: 99%

Thoracic Duct Injury Following Cervical Spine Surgery: A Multicenter Retrospective Review

Derakhshan

Lubelski

Steinmetz

et al. 2017

Global Spine Journal

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Study Design:Multicenter retrospective case series.Objective:To determine the rate of thoracic duct injury during cervical spine operations.Methods:A retrospective case series study was conducted among 21 high-volume surgical centers to identify instances of thoracic duct injury during anterior cervical spine surgery. Staff at each center abstracted data for each identified case into case report forms. All case report forms were collected by the AOSpine North America Clinical Research Network Methodological Core for data processing, cleaning, and analysis.Results:Of a total of 9591 patients reviewed that underwent cervical spine surgery, 2 (0.02%) incurred iatrogenic injury to the thoracic duct. Both patients underwent a left-sided anterior cervical discectomy and fusion. The interruption of the thoracic duct was addressed intraoperatively in one patient with no residual postoperative effects. The second individual developed a chylous fluid collection approximately 2 months after the operation that required drainage via needle aspiration.Conclusions:Damage to the thoracic duct during cervical spine surgery is a relatively rare occurrence. Rapid identification of the disruption of this lymphatic vessel is critical to minimize deleterious effects of this complication.

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Section: Discussionmentioning

confidence: 99%

Thoracic Duct Injury Following Cervical Spine Surgery: A Multicenter Retrospective Review

Derakhshan

Lubelski

Steinmetz

et al. 2017

Global Spine Journal

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“…Hierzu erfolgt zunächst die Punktion eines geeigneten Lymphgefäßes und anschließend das Auffädeln des Ductus thoracicus und Verschluss unterhalb des Lecks. Bei 30 % der Patienten kann kein geeignetes Lymphgefäß punktiert werden; gelingt die Punktion, liegt die Erfolgsrate aber bei 90 % [47,48]. Radiologische Verfahren bieten eine minimalinvasive Alternative zur chirurgischen Intervention, sind aber aktuell weniger zuverlässig als chirurgische Verfahren [41].…”

Section: Alternative Behandlungsmethodenunclassified

Prävention und operative Therapie des Chylothorax

2018

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“…Thoracic duct lymphangiography and embolization is a novel, less invasive and potentially equally efficacious treatment method (44,46,47).…”

Section: Discussionmentioning

confidence: 99%

Early Postoperative Complications of Thoracic Esophageal Diverticula: A Review of 10 Cases from "Saint Mary" Hospital, Bucharest, Romania

Gîndea¹,

Constantin²,

Hoara³

et al. 2018

chr

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RezumatIntroducere: Diverticulul esofagian toracic reprezintă o patologie rară, frecvent asociată cu tulburări de motilitate esofagiană. Chirurgia reprezintă singura opţiune terapeutică la pacienţii cu simptome severe. Metodă: Studiu retrospectiv pe un lot de 10 pacienţi ce au suferit diverticulectomie pentru simptomatologia provocată de diverticulii epifrenici sau medio-toracici. Au fost înregistrate principalele simptome preoperatorii, analizele de sânge uzuale, tranzitul baritat, endoscopia superioară şi manometria esofagiană. Am analizat complicaţiile postoperatorii, durata de spitalizare şi perioada petrecută la terapie intensivă. Rezultate: Majoritatea pacienţilor au prezentat regurgitaţii, disfagie sau ambele. Abordul chirurgical a fost prin toracotomie stângă sau pe cale abdominală pentru diverticulii epifrenici şi prin toracotomie dreaptă sau toracoscopie pentru diverticulii mediotoracici. 4 pacienţi au prezentat complicaţii severe: 3 fistule majore (un deces) şi un chilotorax. Discuţii: Chirurgia diverticulilor toracici este asociata cu rate mari de mobiditate şi mortalitate. Fistula produsă la nivelul liniei de sutură este cea mai frecventa complicaţie, spre deosebire de chilotorax ce survine mai rar. Concluzii: Diverticulul esofagian toracic voluminos este o patologie benignă cu complicaţii "maligne". O evaluare preoperatorie Chirurgia, 113 (1), 2018 www.revistachirurgia.ro 145

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Percutaneous embolization of thoracic duct injury post-esophagectomy should be considered initial treatment for chylothorax before proceeding with open re-exploration

Cited by 27 publications

References 22 publications

Thoracic Duct Injury Following Cervical Spine Surgery: A Multicenter Retrospective Review

Thoracic Duct Injury Following Cervical Spine Surgery: A Multicenter Retrospective Review

Prävention und operative Therapie des Chylothorax

Early Postoperative Complications of Thoracic Esophageal Diverticula: A Review of 10 Cases from "Saint Mary" Hospital, Bucharest, Romania

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