초록접수 현황
| 16F-048 | 포럼 발표 |
Thoracic Duct Embolization for Treatment of Chylothorax
Seok Jin Haam, Joonho Jung, Jiye Park, Seong Yong Park
Department of Thoracic and Cardiovascular Surgery, Ajou University Hospital, Ajou University School of Medicine, Gyeonggi-do, Korea
Background : Chylothorax after thoracic surgery is uncommon complication. Prolonged loss of chyle may lead to fatal outcome due to immunologic compromise or nutritional deficit. There are some treatment modalities for chylothorax, transpleural thoracic duct ligation and non-surgical methods such as fast, lipid-free diet and chemical pleurodesis. Nowadays, there are some reports with successful outcomes about thoracic duct embolization (TDE) for interventional treatment of chylothorax, so we report 3 cases of chylothorax treated with TDE.
Methods : There were 3 patients who developed chylothorax after thoracic surgery in our center. Patient 1 developed after right upper lobectomy for lung cancer, the others developed after esophagectomy and reconstruction for esophageal cancer.
Direct puncture of inguinal lymph node under ultrasound guidance, lipiodol was injected under fluoroscopic-assist for identification of lymphatic channels. After visualization of lymphatic channels, we could access to retroperitoneal large lymphatic duct using transabdominal approach with long needle under fluoroscopic-assist. Using micro-wire and injection of contrast, we could identify the thoracic duct and site of leakage. The coil and N-butyl cyanoacrylate glue were used for embolization.
Results : In patient 1, the drainage of chest tube was significantly decreased after TDE. We could remove all drainage catheters 5 days after TDE and he had discharged the next day. The others, cases of esophageal surgery, needed more time to remove chest tubes, but we could remove chest tubes within 10 days after TDE. There were no complications related with TDE.
Conclusion : TDE is safe and effective method for treatment of post-surgical chylothorax.
Methods : There were 3 patients who developed chylothorax after thoracic surgery in our center. Patient 1 developed after right upper lobectomy for lung cancer, the others developed after esophagectomy and reconstruction for esophageal cancer.
Direct puncture of inguinal lymph node under ultrasound guidance, lipiodol was injected under fluoroscopic-assist for identification of lymphatic channels. After visualization of lymphatic channels, we could access to retroperitoneal large lymphatic duct using transabdominal approach with long needle under fluoroscopic-assist. Using micro-wire and injection of contrast, we could identify the thoracic duct and site of leakage. The coil and N-butyl cyanoacrylate glue were used for embolization.
Results : In patient 1, the drainage of chest tube was significantly decreased after TDE. We could remove all drainage catheters 5 days after TDE and he had discharged the next day. The others, cases of esophageal surgery, needed more time to remove chest tubes, but we could remove chest tubes within 10 days after TDE. There were no complications related with TDE.
Conclusion : TDE is safe and effective method for treatment of post-surgical chylothorax.
책임저자: Seong Yong Park
Department of Thoracic and Cardiovascular Surgery, Ajou University Hospital, Ajou University School of Medicine, Gyeonggi-do, Korea
발표자: Joonho Jung, E-mail : alien31337@hanmail.net