title: Closure of the thoracic duct from the left-side access: A case report.
abstract: BACKGROUND
  We report a 16-year-old patient with a massive left-sided chylothorax after chemotherapy due to mixed germinal tumor of the testis with massive metastases located in the retroperitoneal space and posterior mediastinum. Chemotherapy resolved the metastases in the mediastinum but evoked a huge pleural effusion in the left pleural cavity, requiring surgical intervention.Left-sided access was used. The 5-mm camera and 3 5-mm working ports were inserted. The parietal pleura was incised and the esophagus located and protected. Behind the esophagus, the thoracic duct and concomitant tissue were clipped with titanium clips, and additionally, thrombin glue was used. Stopping of the lymph leakage was observed during surgery. A local argon pleurodesis was used to finish the procedure. The thoracic tube was removed on the third postoperative day.
  
  
  CONCLUSIONS
  Left-side access may be a good alternative in the left-sided chylothorax, but the crucial points are location and protection of the esophagus during the procedure, which is also the landmark that allows for locating the thoracic duct.
authors: Clinic of Pediatric Surgery and Traumatology Clinic of Pediatrics Hematology and Oncology Department of Pediatric Radiology Clinic of Pediatrics, Medical University of Lublin, Lublin, Poland.
authors: Paweł
authors: P
authors: Nachulewicz
authors: Anna
authors: A
authors: Golonka
authors: Tomasz
authors: T
authors: Żądkowski
authors: Paweł
authors: P
authors: Osemlak
authors: Joanna
authors: J
authors: Nużyńska-Flak
authors: Agnieszka
authors: A
authors: Brodzisz
authors: Elżbieta
authors: E
authors: Pac-Kożuchowska
mesh_terms: D000293:Adolescent; D002916:Chylothorax / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000556:secondary*; D009373:Neoplasms, Germ Cell and Embryonal / Q000556:secondary*; D012186:Retroperitoneal Neoplasms / Q000556:secondary*; D000071062:Sutureless Surgical Procedures; D013736:Testicular Neoplasms / Q000473:pathology*; D013897:Thoracic Duct / Q000601:surgery*; D013906:Thoracoscopy / Q000379:methods*