Prone-Position Thoracoscopic Ligation of the Thoracic Duct for Chyle Leak Following Radical Neck Dissection in a Patient with a Right Aortic Arch

Acta Med Okayama. 2015;69(3):173-6. doi: 10.18926/AMO/53524.

Abstract

A chyle leak can occur as a complication after neck or chest surgery. Such a leak prolongs the hospital stay and is sometimes life-threatening. The treatment options are conservative management, interventional radiologic embolization, and surgery. Thoracoscopic ligation of the thoracic duct has emerged as a promising and definitive treatment. The case of a 65-year-old Japanese male patient with a rare congenital right aortic arch (typeⅢB1 of Edward's classification) and a severe chyle leak that occurred after a total pharyngolaryngo-esophagectomy (TPLE) is described. The chyle leak was successfully managed by thoracoscopic ligation of the thoracic duct via a left-side approach with the patient in the prone position.

MeSH terms

  • Aged
  • Aorta, Thoracic / abnormalities*
  • Chyle*
  • Esophagectomy
  • Humans
  • Ligation
  • Male
  • Neck Dissection / adverse effects*
  • Prone Position
  • Thoracic Duct / surgery*
  • Thoracoscopy / methods*