title: [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 The pleural effusion drainage decreased immediately, and the thoracic drain was withdrawn 5-9 days after lymphangiography in 4 cases.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.affiliation: Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine.
authors.forename: Shingo
authors.initials: S
authors.lastname: Nakashima
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiozaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Konishi
authors.forename: Shuhei
authors.initials: S
authors.lastname: Komatsu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kubota
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Ryo
authors.initials: R
authors.lastname: Morimura
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Murayama
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuriu
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ikoma
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Chouhei
authors.initials: C
authors.lastname: Sakakura
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D000368:Aged; D002916:Chylothorax / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D004322:Drainage; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008220:Lymphography; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000209:etiology / Q000628:therapy; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*