Treatment Of Post-Operative Chylothorax: The Role Of Intranodal Lymphangiography And Thoracic Duct Disruption

Bibliographic Details
Main Author: Torres, Tiago Paulino
Publication Date: 2024
Other Authors: Costa, Pedro, Moreira, Herculano, Dionísio, Teresa, Sousa, Pedro
Format: Article
Language: eng
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: https://doi.org/10.48729/pjctvs.343
Summary: Thoracic duct embolization has been increasingly adopted as a first-line therapy of chylothorax and this procedure includes lipiodol lymphangiography, thoracic duct access and embolization. Lymphangiography itself has a therapeutic role, with volume-dependent success rates of 37%-97% and even a reported 100% success rate in outputs of < 500 mL/day. We present a clinical case of a 48-years-old man diagnosed with esophageal squamous cell carcinoma, who underwent esophagectomy and presented with post-operative high-output (> 1L/day) chylothorax; thoracic duct embolization was proposed. Even though thoracic duct access and embolization were not achieved due to technical and anatomical factors, lipiodol lymphangiography and possibly thoracic duct maceration (after several punctures/attempts) contributed to the clinical success of the procedure, and this chylothorax with output values superior to those reported in the literature resolved within three days. As such, the therapeutic role of intranodal lymphangiography and thoracic duct disruption should be taken into account.
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spelling Treatment Of Post-Operative Chylothorax: The Role Of Intranodal Lymphangiography And Thoracic Duct DisruptionChylothoraxLymphangiographyLipiodolThoracic ductInterventional RadiologyThoracic duct embolization has been increasingly adopted as a first-line therapy of chylothorax and this procedure includes lipiodol lymphangiography, thoracic duct access and embolization. Lymphangiography itself has a therapeutic role, with volume-dependent success rates of 37%-97% and even a reported 100% success rate in outputs of < 500 mL/day. We present a clinical case of a 48-years-old man diagnosed with esophageal squamous cell carcinoma, who underwent esophagectomy and presented with post-operative high-output (> 1L/day) chylothorax; thoracic duct embolization was proposed. Even though thoracic duct access and embolization were not achieved due to technical and anatomical factors, lipiodol lymphangiography and possibly thoracic duct maceration (after several punctures/attempts) contributed to the clinical success of the procedure, and this chylothorax with output values superior to those reported in the literature resolved within three days. As such, the therapeutic role of intranodal lymphangiography and thoracic duct disruption should be taken into account.SOCIEDADE PORTUGUESA DE CIRURGIA CARDIO-TORÁCICA E VASCULAR2024-02-09info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48729/pjctvs.343https://doi.org/10.48729/pjctvs.343Portuguese Journal of Cardiac Thoracic and Vascular Surgery; Vol. 30 No. 4 (2023): Oct-Dec; 67-702184-9927reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAPenghttps://pjctvs.com/index.php/journal/article/view/343https://pjctvs.com/index.php/journal/article/view/343/350Copyright (c) 2023 Portuguese Journal of Cardiac Thoracic and Vascular Surgeryinfo:eu-repo/semantics/openAccessTorres, Tiago PaulinoCosta, PedroMoreira, HerculanoDionísio, TeresaSousa, Pedro2024-02-10T05:03:12Zoai:oai.pjctvs.com:article/343Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T13:21:27.343233Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Treatment Of Post-Operative Chylothorax: The Role Of Intranodal Lymphangiography And Thoracic Duct Disruption
title Treatment Of Post-Operative Chylothorax: The Role Of Intranodal Lymphangiography And Thoracic Duct Disruption
spellingShingle Treatment Of Post-Operative Chylothorax: The Role Of Intranodal Lymphangiography And Thoracic Duct Disruption
Torres, Tiago Paulino
Chylothorax
Lymphangiography
Lipiodol
Thoracic duct
Interventional Radiology
title_short Treatment Of Post-Operative Chylothorax: The Role Of Intranodal Lymphangiography And Thoracic Duct Disruption
title_full Treatment Of Post-Operative Chylothorax: The Role Of Intranodal Lymphangiography And Thoracic Duct Disruption
title_fullStr Treatment Of Post-Operative Chylothorax: The Role Of Intranodal Lymphangiography And Thoracic Duct Disruption
title_full_unstemmed Treatment Of Post-Operative Chylothorax: The Role Of Intranodal Lymphangiography And Thoracic Duct Disruption
title_sort Treatment Of Post-Operative Chylothorax: The Role Of Intranodal Lymphangiography And Thoracic Duct Disruption
author Torres, Tiago Paulino
author_facet Torres, Tiago Paulino
Costa, Pedro
Moreira, Herculano
Dionísio, Teresa
Sousa, Pedro
author_role author
author2 Costa, Pedro
Moreira, Herculano
Dionísio, Teresa
Sousa, Pedro
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Torres, Tiago Paulino
Costa, Pedro
Moreira, Herculano
Dionísio, Teresa
Sousa, Pedro
dc.subject.por.fl_str_mv Chylothorax
Lymphangiography
Lipiodol
Thoracic duct
Interventional Radiology
topic Chylothorax
Lymphangiography
Lipiodol
Thoracic duct
Interventional Radiology
description Thoracic duct embolization has been increasingly adopted as a first-line therapy of chylothorax and this procedure includes lipiodol lymphangiography, thoracic duct access and embolization. Lymphangiography itself has a therapeutic role, with volume-dependent success rates of 37%-97% and even a reported 100% success rate in outputs of < 500 mL/day. We present a clinical case of a 48-years-old man diagnosed with esophageal squamous cell carcinoma, who underwent esophagectomy and presented with post-operative high-output (> 1L/day) chylothorax; thoracic duct embolization was proposed. Even though thoracic duct access and embolization were not achieved due to technical and anatomical factors, lipiodol lymphangiography and possibly thoracic duct maceration (after several punctures/attempts) contributed to the clinical success of the procedure, and this chylothorax with output values superior to those reported in the literature resolved within three days. As such, the therapeutic role of intranodal lymphangiography and thoracic duct disruption should be taken into account.
publishDate 2024
dc.date.none.fl_str_mv 2024-02-09
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://doi.org/10.48729/pjctvs.343
https://doi.org/10.48729/pjctvs.343
url https://doi.org/10.48729/pjctvs.343
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://pjctvs.com/index.php/journal/article/view/343
https://pjctvs.com/index.php/journal/article/view/343/350
dc.rights.driver.fl_str_mv Copyright (c) 2023 Portuguese Journal of Cardiac Thoracic and Vascular Surgery
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2023 Portuguese Journal of Cardiac Thoracic and Vascular Surgery
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv SOCIEDADE PORTUGUESA DE CIRURGIA CARDIO-TORÁCICA E VASCULAR
publisher.none.fl_str_mv SOCIEDADE PORTUGUESA DE CIRURGIA CARDIO-TORÁCICA E VASCULAR
dc.source.none.fl_str_mv Portuguese Journal of Cardiac Thoracic and Vascular Surgery; Vol. 30 No. 4 (2023): Oct-Dec; 67-70
2184-9927
reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron:RCAAP
instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
institution RCAAP
reponame_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
collection Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository.name.fl_str_mv Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
repository.mail.fl_str_mv info@rcaap.pt
_version_ 1833593694722195456

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