Embolization of the thoracic duct in patients with iatrogenic chylothorax
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Embolization of the thoracic duct in patients with iatrogenic chylothorax. / Bazancir, Laser Arif; Jensen, Ruben Juhl; Frevert, Susanne Christiansen; Ryom, Philip; Achiam, Michael Patrick.
I: Diseases of the Esophagus, Bind 34, Nr. 9, doab001, 2021.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Embolization of the thoracic duct in patients with iatrogenic chylothorax
AU - Bazancir, Laser Arif
AU - Jensen, Ruben Juhl
AU - Frevert, Susanne Christiansen
AU - Ryom, Philip
AU - Achiam, Michael Patrick
N1 - Publisher Copyright: © The Author(s) 2021.
PY - 2021
Y1 - 2021
N2 - Chylothorax is leakage of lymphatic fluid accumulating in the pleural cavity due to the thoracic duct's (TD) trauma or obstructions. It generally occurs as a traumatic complication after general thoracic surgery procedures (0.4%), especially after esophagectomy (4.7-8.6%). Traditionally, surgical intervention is performed if conservative management fails, but reports of high mortality (2.1%) and morbidity (38%) have led to the development of a minimally invasive percutaneous treatment method; TD embolization (TDE). The records of all patients treated for chylothorax with TDE from April 2015 to June 2019 were reviewed. Only patients with iatrogenic chylothorax were included. The outcomes measures are defined as a technical and a clinical success. A technical success, is defined as the ability to perform the embolization procedure, thereby injecting embolizing material Histoacryl with or without coils. A clinical success is defined as a complete cessation of lymphatic leakage into the pleural cavity without surgical intervention and, therefore, a cured patient. Lymphography was performed in all patients, and visualization of cisterna chyli was achieved in 14/17 patients (82.4%). Of the 17 patients included, 15 patients were successfully embolized and cured of chylothorax (88.2%). Successfully embolized patients had a median discharge time of 7 days. Most patients reported postprocedural pain, which was dealt with using conventional pain medication. TDE seems like a safe percutaneous treatment technique with a high clinical success rate in iatrogenic chylothorax patients which can be readily implemented if the clinical experience is available.
AB - Chylothorax is leakage of lymphatic fluid accumulating in the pleural cavity due to the thoracic duct's (TD) trauma or obstructions. It generally occurs as a traumatic complication after general thoracic surgery procedures (0.4%), especially after esophagectomy (4.7-8.6%). Traditionally, surgical intervention is performed if conservative management fails, but reports of high mortality (2.1%) and morbidity (38%) have led to the development of a minimally invasive percutaneous treatment method; TD embolization (TDE). The records of all patients treated for chylothorax with TDE from April 2015 to June 2019 were reviewed. Only patients with iatrogenic chylothorax were included. The outcomes measures are defined as a technical and a clinical success. A technical success, is defined as the ability to perform the embolization procedure, thereby injecting embolizing material Histoacryl with or without coils. A clinical success is defined as a complete cessation of lymphatic leakage into the pleural cavity without surgical intervention and, therefore, a cured patient. Lymphography was performed in all patients, and visualization of cisterna chyli was achieved in 14/17 patients (82.4%). Of the 17 patients included, 15 patients were successfully embolized and cured of chylothorax (88.2%). Successfully embolized patients had a median discharge time of 7 days. Most patients reported postprocedural pain, which was dealt with using conventional pain medication. TDE seems like a safe percutaneous treatment technique with a high clinical success rate in iatrogenic chylothorax patients which can be readily implemented if the clinical experience is available.
KW - Chyle leak
KW - Lymphatic intervention
KW - Lymphography
KW - Thoracic duct embolization
KW - Thoracic duct ligation
KW - Traumatic chylothorax
U2 - 10.1093/dote/doab001
DO - 10.1093/dote/doab001
M3 - Journal article
C2 - 33550366
AN - SCOPUS:85116172747
VL - 34
JO - Diseases of the Esophagus (Print)
JF - Diseases of the Esophagus (Print)
SN - 1120-8694
IS - 9
M1 - doab001
ER -
ID: 301442195