Results of prophylactic thoracic duct ligation in advanced esophageal carcinoma |
| |
Authors: | Mohsen Sokouti Vahid Montazeri |
| |
Institution: | (1) Department of Thoracic Surgery, Imam Khomeini Hospital, Tabriz University of Medical Sciences, Tabriz, Iran |
| |
Abstract: | Objective Esophageal carcinoma is one of the most common lethal malignancies in northwest Iran. The purpose of this study is to determine
the efficiency of prophylactic thoracic duct ligation and compare the incidence, risk factors and outcomes of chylothorax
in patients undergoing esophageal cancer surgery.
Methods and Material From 1995 through 2005 a total 420 patients undergoing esophageal resection with or without mediastinal lymph node dissection.
In first five years (Group I: 210 patients) that after any esophagectomies we have not used prophylactic thoracic duct ligation
(1995–2000). In last five years for prevention of chylothorax after any esophagectomies (Group II: 210 patients), thirty patients
with advanced stage of esophageal carcinoma underwent to prophylactic thoracic duct ligation (2000–2005). Data analysis included
Chi-square or Fisher exact test and Independent Samples t test. A p-value of <0.05 was considered significant. All analyzes
were performed using the SPSS.15/win software.
Results There were 100 men and 110 women with a mean age of 53.18±12.35 years in Group I, 108 men and 102 women with a mean age of
56.1±9.83 years in Group II. The initial procedures were transhiatal esophagectomies and transthoracic esophagectomies. Six
patients of group I, developed to chylothorax with average daily postoperative drainage greater than 1000 ml/day for 6 days,
and underwent to reoperation at a mean of 7.12±1.85 days after diagnosis (4–8 days). Chest tube drainage was stopped during
48 hours after reoperation. In Group II chylothorax did not occur.
Conclusions Chylothorax increases mortality and duration of hospitalization after esophageal cancer surgery. Most cases of chylothorax
after esophageal resection are cured with early surgical intervention. It could be concluded that prophylactic thoracic duct
ligation reduce the occurrence of chylothorax in advanced cases of esophageal carcinoma. |
| |
Keywords: | Key-words" target="_blank">Key-words Thoracic duct Mediastinal lymph nodes Traumatic |
本文献已被 SpringerLink 等数据库收录! |
|