title: A unique approach to thoracic duct leak after esophagectomy.
abstract: Chylothorax is a severe complication of esophagectomy. Those who do not respond to conservative measures require reoperation. We have described a minimally invasive technique to control a late postoperative chyle leak. A 41-year-old patient underwent an Ivor-Lewis esophagectomy. Day 4 after surgery he was found to have an esophageal leak. He underwent thoracotomy and esophageal stent insertion. On day 20, a radiologic drain was placed to control a small supradiaphragmatic collection. The collection was found to be chyle, and 2.5 L was drained per day. As this was 3 weeks after thoracotomy, a technique of sinus track dilatation and cavity visualization was carried out with clipping of the chyle channel. The patient recovered well from the procedure. He was extubated postoperatively and only required simple analgesia.
authors: *Department of Surgery, Tauranga Hospital, Tauranga †Department of Surgery, Faculty of medical and Health Sciences, University of Auckland, Grafton, Auckland, New Zealand.
authors: W A Firdaus
authors: WA
authors: W A Aziz
authors: Jeremy I
authors: JI
authors: Rossaak
mesh_terms: D000328:Adult; D057868:Anastomotic Leak / Q000175:diagnosis / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D002916:Chylothorax / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy / Q000009:adverse effects*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008482:Mediastinum; D012086:Reoperation; D013906:Thoracoscopy / Q000379:methods*; D013908:Thoracotomy / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed