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pleural effusion drainage decreased immediately, and the thoracic drain was withdrawn 5-9 days after lymphangiography in 4 cases.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.