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Thoracoscopic management of cervical thoracic duct injuries after thyroidectomy with lymphadenectomy
Author(s) -
Ikeda Yoshifumi
Publication year - 2014
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12075
Subject(s) - medicine , surgery , thoracic duct , fistula , thoracoscopy , ligation , chest tube , pneumothorax , lymphatic system , immunology
Abstract We present a case of postoperative cervical chylous fistula after neck dissection of advanced thyroid carcinoma that was managed successfully by thoracoscopic ligation of the thoracic duct. A double lumen endobronchial tube was introduced for selective single‐lung ventilation with the patient under general anesthesia. The patient was placed in the left decubitus position. Four thoracoports were introduced in the collapsed right lung. The thoracic duct was ligated at two points, and two clips were applied. Postoperatively, neck drainage ceased immediately. The chest tube and closed neck drains were removed on postoperative days 2 and 8, respectively. The patient was discharged on postoperative day 9. Thoracoscopy is a safe and effective treatment of chylous fistula in the neck. Compared to the open procedure, the minimally invasive thoracoscopic approach causes less pain and fosters faster rehabilitation and recovery.