Computed tomography-guided lymphangiography from the para-aortic lymph node: a useful approach for chylothorax after esophagectomy.
CT-guided
Chylothorax
Esophageal cancer
Lipiodol
Lymphangiography
Journal
General thoracic and cardiovascular surgery
ISSN: 1863-6713
Titre abrégé: Gen Thorac Cardiovasc Surg
Pays: Japan
ID NLM: 101303952
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
received:
15
09
2021
accepted:
21
10
2021
pubmed:
30
10
2021
medline:
3
3
2022
entrez:
29
10
2021
Statut:
ppublish
Résumé
Chylothorax is a relatively rare complication of esophagectomy but can lead to fatal conditions. The aim of this report was to present a case of lymphangiography from the para-aortic lymph node (PALN) under computed tomography (CT) guidance, which could be an alternative modality to ultrasound sonography from the groin. A 58-year-old man was diagnosed as having postoperative chylothorax after esophagectomy following neoadjuvant chemotherapy. As the pleural effusion did not improve, intranodal lipiodol lymphangiography from the inguinal lymph node was performed but was unsuccessful. Therefore, CT-guided lymphangiography from the left PALN was performed, and the pleural effusion drainage significantly disappeared. CT-guided lipiodol lymphangiography from the PALN for chylothorax after esophagectomy was safe and thus can be considered an alternative treatment option to ultrasonography-guided intranodal lymphangiography. The flexible use of CT and ultrasonography for lymphangiography may improve the treatment outcomes of chylothorax after esophagectomy.
Sections du résumé
BACKGROUND
BACKGROUND
Chylothorax is a relatively rare complication of esophagectomy but can lead to fatal conditions. The aim of this report was to present a case of lymphangiography from the para-aortic lymph node (PALN) under computed tomography (CT) guidance, which could be an alternative modality to ultrasound sonography from the groin.
CASE PRESENTATION
METHODS
A 58-year-old man was diagnosed as having postoperative chylothorax after esophagectomy following neoadjuvant chemotherapy. As the pleural effusion did not improve, intranodal lipiodol lymphangiography from the inguinal lymph node was performed but was unsuccessful. Therefore, CT-guided lymphangiography from the left PALN was performed, and the pleural effusion drainage significantly disappeared.
CONCLUSIONS
CONCLUSIONS
CT-guided lipiodol lymphangiography from the PALN for chylothorax after esophagectomy was safe and thus can be considered an alternative treatment option to ultrasonography-guided intranodal lymphangiography. The flexible use of CT and ultrasonography for lymphangiography may improve the treatment outcomes of chylothorax after esophagectomy.
Identifiants
pubmed: 34714472
doi: 10.1007/s11748-021-01727-w
pii: 10.1007/s11748-021-01727-w
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
308-311Informations de copyright
© 2021. The Japanese Association for Thoracic Surgery.
Références
Merigliano S, Molena D, Ruol A, Zaninotto G, Cagol M, Scappin S, et al. Chylothorax complicating esophagectomy for cancer: a plea for early thoracic duct ligation. J Thorac Cardiovase Surg. 2000;119(3):453–7.
doi: 10.1016/S0022-5223(00)70123-1
Jenani SR, Carlos AP, Chris JR, Mark SA, Emily B, Stephen DC, et al. Treatment of postsurgical chyloyhorax. Ann Thoracic Surg. 2018;105:254–62.
doi: 10.1016/j.athoracsur.2017.07.021
Jiajia L, Sato Y, Motoyoma S, Ishiyama K, Yamada K, Yamamoto M, et al. Ultrasound-guided intranodal lipiodol lymphangiography from the groin is useful for assessment and treatment of post-esophagectomy chylothorax in three cases. Int J Surg Case Rep. 2016;29:103–7.
doi: 10.1016/j.ijscr.2016.10.069
Hirata M, Shimizu A, Abe S, Ichinose A, Sugiyama A, Tanino Y, et al. CT-guided intranodal lymphangiography for postoperative chylous ascites. Cardiovasc Intervent Radiol. 2017;40:1281–4.
doi: 10.1007/s00270-017-1644-y
Sommer CM, Pieper CC, Offensperger F, Pan F, Killguss HJ, Koninger J, et al. Radiological management of postoperative lymphorrhea. Langenbecks Arch Surg. 2021;406(4):945–69. https://doi.org/10.1007/s00423-021-02094-z (Epub 2021 Apr 12).
doi: 10.1007/s00423-021-02094-z
pubmed: 33844077
Tomita K, Iguchi T, Hiraki T, Matsui Y, Uka M, Komaki T, et al. Computed tomography fluroscopy-guided core needle biopsy of abdominal para-aortic lesions: a retrospective evaluation of the diagnostic yield and safety. Intervent Radiol. 2003;23:1541–60.
Guermazi A, Brice P, Hennequin C, Sarfati E. Lymphography: an old technique retains its usefulness. Radiographics. 2020;5:128–33.
Kranzfelder M, Schuster T, Geinitz H, Friess H, Buchler P. Meta-analysis of neoadjuvant treatment modalities and defenitive non-surgical therapy for oesophageal squamous cell cancer. Br J Surg. 2011;98:768–83.
doi: 10.1002/bjs.7455
Kranzfelder M, Gertler R, Hapfelmeier A, Friess H, Feith M. Chylothorax after esophagectomy for cancer: impact of the surgical approach and neoadjuvant treatment: systematic review and institutional analysis. Surg Endose. 2013;27:3530–8.
doi: 10.1007/s00464-013-2991-7