Document Detail


Thoracoscopic management of chylothorax complicating esophagectomy.
MedLine Citation:
PMID:  11814127     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Chylothorax is a relatively uncommon complication of esophageal surgery that may lead to severe respiratory, nutritional, and immunologic deficiencies. PATIENTS AND METHODS: Between 1992 and 2000, 3 of 316 patients (0.9%) undergoing transthoracic esophagectomy for carcinoma developed postoperative chylothorax. Two of them had previously been treated with neoadjuvant chemoradiation, and one had been submitted to esophagogastric resection through a left thoracotomy. After a 2-week trial of total parenteral nutrition and drainage, two patients underwent thoracic duct ligation via thoracotomy. In the last patient, the operation was completed by thoracoscopy. The azygos vein and the periaortic tissue above the diaphragm were encircled en bloc by a right-angled clamp, and a roticulating endostapler was applied. RESULTS: Reoperation was successful in all patients. The postoperative hospital stay was 4 days. CONCLUSION: Thoracoscopy is a safe and effective procedure for the treatment of chylothorax complicating esophagectomy. Given the minimal trauma to the patient, early thoracoscopic reoperation can be advocated in patients with high-output chyle loss in order to reduce the hospital stay.
Authors:
L Bonavina; G Saino; D Bona; M Abraham; A Peracchia
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of laparoendoscopic & advanced surgical techniques. Part A     Volume:  11     ISSN:  1092-6429     ISO Abbreviation:  J Laparoendosc Adv Surg Tech A     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2002-01-29     Completed Date:  2002-05-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9706293     Medline TA:  J Laparoendosc Adv Surg Tech A     Country:  United States    
Other Details:
Languages:  eng     Pagination:  367-9     Citation Subset:  IM    
Affiliation:
Department of Surgical Sciences, University of Milan, Ospedale Maggiore di Milano, Italy. bonavina@polic.cilea.it
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / surgery
Azygos Vein / surgery
Carcinoma, Squamous Cell / surgery
Chylothorax / etiology,  surgery*
Drainage
Esophageal Neoplasms / surgery
Esophagectomy / adverse effects*
Humans
Ligation
Middle Aged
Parenteral Nutrition
Thoracic Duct / surgery
Thoracoscopy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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