Three Cases of Chylothorax following Resection for the Esophageal Carcinoma

DOI 参考文献25件
  • NAKATA Yoshitaka
    The Second Department of Surgery, Kyorin University School of Medicine
  • GOYA Tomoyuki
    The Second Department of Surgery, Kyorin University School of Medicine
  • HANAOKA Tateo
    The Second Department of Surgery, Kyorin University School of Medicine
  • HANAKUBO Satoru
    The Second Department of Surgery, Kyorin University School of Medicine
  • KOIDO Shojiro
    The Second Department of Surgery, Kyorin University School of Medicine
  • FUKUSHIMA Jun-ichi
    The Second Department of Surgery, Kyorin University School of Medicine
  • YANAGIDA Osamu
    The Second Department of Surgery, Kyorin University School of Medicine
  • KOBAYASHI Yukari
    The Second Department of Surgery, Kyorin University School of Medicine
  • TERAOKA Hideo
    The Second Department of Surgery, Kyorin University School of Medicine

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Between March 1973 and December 1994, we performed 346 esophagectomies for primary esophageal carcinoma, and encountered three patients (0.8 %) of chylothorax that developed following esophagectomy. All three patients were successfully treated by surgical procedure. Case 1: A 51-year-old male. A total thoracic esophagectomy was carried out through a right thoracotomy, laparotomy and cervical incision. On the 22 th post-operative day, for the postoperative chylothorax, ligations of the leaking portions of thoracic duct and supradiaphramatic ligation of the thoracic duct was performed through the previous right thoracotomy incision. Case 2 : A 59-year-old male. A total thoracic esophagectomy was carried out through a right thoracotomy, laparotomy, and cervical incision. On the 7th post-operative day, for the postoperative chylothorax, a thoracic duct ligation and convergence ligations of lymphatic duct around the aorta was carried out through the previous laparotomy incision. Case 3 : A 63-year-old male. A total thoracic esophagectomy was carried out through a right thoracotomy, laparotomy and cervical incision. The right chest drainage tube was removed on the 9 th postoperarive day, and enteral nutrition was started. A chest X-ray showed a right hydrothorax on the 16th postoperative day. On the 22 th postoperative day, for postoperative chylothorax, a thoracic duct ligation and convergence ligations of lymhatic duct around the aorta was carried out through the previous laparotomy incision. Our experience suggest that if conservative treatment is not effective, surgical treatment should be positively applied, and it is important to ligate the thoracic duct just above the diaphragm for prevention of postoperative chylothorax following resection of the esophageal carcinoma.

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