Abstract
A 55-year-old man underwent neoadjuvant chemotherapy, followed by thoracoscopic subtotal esophagectomy in the prone position for advanced esophageal cancer, cT2N1M0 cStage II. Large quantities of discharge were drained from a right thoracic drain after the operation. It was clarified to be chylothorax. Despite percutaneous injection of octreotide acetate and management with intravenous hyperalimentation, chylothorax persisted. Thoracic duct embolization was scheduled on the 21st hospital day after the initial surgery. We tried the embolization after lymphography, but failed in wire-guided cannulation. Thoracic duct interruption under fluoroscopy was thus performed. Thereafter chylothorax tended to decrease and the patient was discharged from our hospital on the 30th day after the interruption.
We have experienced a case of intractable chylothorax after surgery for esophageal cancer where chylothorax did not respond to conservative therapy but healed up by thoracic duct interruption. Compared with surgical resection, this method is less invasive for chylothorax after surgery for esophageal cancer and is considered to be an effective option of therapies.
