Low Ligation Of Whole Bunch Thoracic Duct During Surgery Of Esophageal Carcinoma As Prevention For Postoperative Chylothorax: A Clinical Research

ObjectiveTo investigate the effect of low ligation of whole bunch thoracic duct during surgery of esophageal carcinoma on prevention for postoperative chylothorax.MethodsA retrospective analysis was conducted of all patients undergoing esophagectomy between June 2002 and December 2007 (Patients with preoperative radiotherapy or transhiatal esophagectomy were excluded) . Patients in Group A (n=242) were treated with esophagectomy with ligation of thoracic duct (ligation of the entire tissues between aorta, azygos vein and vertebral body at the level of the 8-9th thoracic vertebra), and other patients in Group B (n=138) were treated with esophagectomy alone. The patients with postoperative chylothorax were observed. The statistical analyses were performed with use of SPSS version 12.0 software.ResultsIt took less than 5min to finish the ligation procedure in Group A, and no complicating injury of azygos vein, massive bleeding, and etc, were found. Postoperative chylothorax occurred in 2 patients in Group A(2/242,0.83%), significantly fewer than that in Group B(6/138, 4.35%,P<0.05).ConclusionThe procedure of low ligation of whole bunch thoracic duct during surgery of esophageal carcinoma is safe and feasible, with the acknowledged benefits of preventing postoperative chylothorax.