Prevention of Chylothorax Complicating Extensive Esophageal Resection by Mass Ligation of Thoracic Duct: A Random Control Study

Lai, Fan-Cai; Chen, Long; Tu, Yuan-rong; Lin, Min; Xu, Luping

doi:10.1016/j.athoracsur.2011.02.070

Cited by 90 publications

(56 citation statements)

References 10 publications

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“…Moreover, with the exception of a chylothorax, there was no significant difference in the morbidity of other postoperative complications between the two groups. Other studies also have demonstrated the benefit of thoracic duct ligation with open esophagectomy [23,24]. These results demonstrate that prophylactic thoracic duct ligation during video-assisted thoracoscopic esophagectomy could effectively prevent postoperative chylothorax.…”

Section: Discussionmentioning

confidence: 86%

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

et al. 2011

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Section: Discussionmentioning

confidence: 86%

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

et al. 2011

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“…[5] Furthermore, TD ligation was shown to reduce postoperative chylothorax. [6,7] In contrast, TD ligation was reported to induce retroperitoneal fluid retention and lead to intravenous volume loss after surgery. [8,9] In terms of hepatic damage, Guler et al demonstrated that TD ligation had a negative effect on the liver in a canine model of peritonitis, which was induced by the amount of endotoxin to which the liver was exposed.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcome of transthoracic esophagectomy with thoracic duct resection

Matsuda

Takeuchi²,

Kawakubo³

et al. 2016

Medicine

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The number of dissected lymph nodes (LNs), surgical outcomes, and postoperative recurrence-free survival (RFS) were compared between thoracic duct (TD)-preserved and TD-resected groups. The distribution of metastasis in LNs around TD (TDLN) was reviewed. Transthoracic esophagectomy (TTE) with TD resection for esophageal cancer patients has been one of the standard procedures. Because the adipose tissue surrounding the TD contains LNs, TD resection might be necessary for radical LN dissection. However, few studies have investigated the oncological outcome of TTE with TD resection. Two hundred fifty-six consecutive patients who underwent TTE between 2004 and 2015 were retrospectively reviewed and classified into TD-preserved or TD-resected groups. The number of dissected LNs for each LN station and surgical outcomes were compared. RFS was analyzed in 155 patients who underwent TTE before December 2012. Since 2013, the TDLN number was prospectively examined, independent of the regional LNs (n = 72). Of these, the TDLN number for each location (TDLN-Ut/Mt/Lt) was investigated and the correlation between TDLN metastasis and clinicopathological factors was analyzed. The TD was preserved in 89 patients and resected in 167 patients. Patients with TD resection showed significant advanced stage. There was no significant difference in the incidence of postoperative complications, including pneumonia, anastomotic leakage, and chylothorax. The number of dissected mediastinal LNs was significantly increased in the TD-resected group. The 5-year RFS rate of cStage I patients was 67.3% in the TD-preserved group against 90.3% in the TD-resected group, showing a tendency towards RFS extension that did not quite reach statistical significance (P = 0.055). The mean TDLN-Ut/Mt/Lt numbers were 0.89/0.56/0.44, respectively. Eight of 72 (11%) patients displayed TDLN metastasis. Metastatic TDLNs were observed on the same or cranial level of the primary lesion in 7 of 8 patients. Transthoracic esophagectomy with TD resection could increase the number of dissected mediastinal LNs without increase of postoperative complication. TDLN metastasis was observed in patients with advanced disease. A prospective trial, investigating the survival between TD-preserved and TD-resected groups, should be conducted to clarify if TD should be resected in TTE.

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“…That increases the likelihood of inadvertent injury to thoracic duct during THE. Prophylactic thoracic duct ligation has been recommended by some to prevent this complication in postoperative period and its morbidity [16]. But the evidence supporting routine use of this policy in all patients is conflicting [17].…”

Section: Discussionmentioning

confidence: 99%

Chylothorax after esophagectomy for esophageal cancer: Risk factors and management

Gupta

Singh

Kalia

et al. 2015

Indian J Gastroenterol

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Prevention of Chylothorax Complicating Extensive Esophageal Resection by Mass Ligation of Thoracic Duct: A Random Control Study

Cited by 90 publications

References 10 publications

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

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

Clinical outcome of transthoracic esophagectomy with thoracic duct resection

Chylothorax after esophagectomy for esophageal cancer: Risk factors and management

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