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

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 The pleural effusion drainage decreased immediately, and the thoracic drain was withdrawn 5-9 days after lymphangiography in 4 cases.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

• Authors: Shingo Nakashima, Atsushi Shiozaki, Hitoshi Fujiwara, Hirotaka Konishi, Shuhei Komatsu, Takeshi Kubota, Daisuke Ichikawa, Kazuma Okamoto, Ryo Morimura, Yasutoshi Murayama, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Chouhei Sakakura, Eigo Otsuji
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 40 Issue 12 Pg. 2161-3 (Nov 2013) ISSN: 0385-0684 [Print] Japan
• PMID: 24394046 (Publication Type: Case Reports, Journal Article)

Topics

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