Thorac Cardiovasc Surg 2019; 67(07): 606-609
DOI: 10.1055/s-0038-1677507
How to Do It
Georg Thieme Verlag KG Stuttgart · New York

Laparoscopic Transhiatal Thoracic Duct Ligation for Chylothorax after Esophagectomy

1   Department of Gastric Surgery, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
2   Department of Surgery, Saitama Medical Center, Dokkyo Medical University, Koshigaya, Saitama, Japan
,
Kazuyuki Saito
2   Department of Surgery, Saitama Medical Center, Dokkyo Medical University, Koshigaya, Saitama, Japan
,
Kosuke Hirano
2   Department of Surgery, Saitama Medical Center, Dokkyo Medical University, Koshigaya, Saitama, Japan
,
Masatoshi Oya
2   Department of Surgery, Saitama Medical Center, Dokkyo Medical University, Koshigaya, Saitama, Japan
› Author Affiliations
Further Information

Publication History

25 September 2018

05 December 2018

Publication Date:
22 January 2019 (online)

Abstract

In esophagectomy for thoracic esophageal cancer, chylothorax may develop at a certain frequency. For chylothorax, conservative treatment is selected first, but if it is not improved, thoracic duct (TD) ligation is considered. In general, transthoracic approach is chosen to reach the TD. However, it is sometimes difficult to identify the TD due to adhesion in the thoracic cavity. Hence, we selected a laparoscopic transhiatal approach to the TD. We introduce the procedure of our laparoscopic transhiatal TD ligation technique.

Dr. Yamagata's ORCID is 0000-0003-2624-1251.


 
  • References

  • 1 Nair SK, Petko M, Hayward MP. Aetiology and management of chylothorax in adults. Eur J Cardiothorac Surg 2007; 32 (02) 362-369
  • 2 Mishra PK, Saluja SS, Ramaswamy D, Bains SS, Haque PD. Thoracic duct injury following esophagectomy in carcinoma of the esophagus: ligation by the abdominal approach. World J Surg 2013; 37 (01) 141-146
  • 3 Johnson OW, Chick JF, Chauhan NR. , et al. The thoracic duct: clinical importance, anatomic variation, imaging, and embolization. Eur Radiol 2016; 26 (08) 2482-2493
  • 4 Defize IL, Schurink B, Weijs TJ. , et al. The anatomy of the thoracic duct at the level of the diaphragm: a cadaver study. Ann Anat 2018; 217: 47-53
  • 5 Schumacher G, Weidemann H, Langrehr JM. , et al. Transabdominal ligation of the thoracic duct as treatment of choice for postoperative chylothorax after esophagectomy. Dis Esophagus 2007; 20 (01) 19-23