[Five cases of chylothorax following esophageal carcinoma resection cured by lipiodol lymphangiography]

Gan To Kagaku Ryoho. 2013 Nov;40(12):2161-3.
[Article in Japanese]

Abstract

Chylothorax following resection for esophageal carcinoma is a relatively rare complication. There is no proven therapy for chylothorax. We report 5 cases of chylothorax following resection for esophageal carcinoma that were cured by Lipiodol lymphangiography. The tumor was located in the middle thoracic esophagus and cervical esophagus in 4 and 1 cases, respectively. The depth of tumor invasion before preoperative therapy was T4 and T1b in 3 and 2 cases, respectively. The thoracic duct was ligated and resected in 2 cases and preserved in 3 cases. Chylothorax was diagnosed on the basis of the identification of chyle-like hydrothorax, and conservative therapy was initiated in all cases. However, it was not effective. Therefore, continuous subcutaneous octreotide was instituted in 3 cases. The discharge from the thoracic tube persisted. Eventually, Lipiodol lymphangiography was performed in all cases. The pleural effusion drainage decreased immediately, and the thoracic drain was withdrawn 5-9 days after lymphangiography in 4 cases. However, the volume of discharge did not change, and therefore, thoracic duct ligation was performed in 1 case. Lipiodol lymphangiography was performed for chylothorax following esophageal carcinoma resection in 5 cases. It was effective in 4 cases. Lipiodol lymphangiography may be an effective therapeutic method for treating conventionally untreatable chylothorax.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Chylothorax / diagnostic imaging
  • Chylothorax / etiology
  • Chylothorax / therapy*
  • Drainage
  • Esophageal Neoplasms / surgery*
  • Female
  • Humans
  • Lymphography
  • Male
  • Middle Aged
  • Pleural Effusion / etiology
  • Pleural Effusion / therapy
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / therapy*