thoracic duct
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Medicine ◽  
2021 ◽  
Vol 100 (50) ◽  
pp. e28213
Author(s):  
Julie Planchette ◽  
Clara Jaccard ◽  
Audrey Nigron ◽  
Jean-Baptiste Chadeyras ◽  
Guillaume Le Guenno ◽  
...  

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Taro Oshikiri ◽  
Hodaka Numasaki ◽  
Junya Oguma ◽  
Yasushi Toh ◽  
Masayuki Watanabe ◽  
...  

Author(s):  
Thomas G. Barnes ◽  
Thomas MacGregor ◽  
Bruno Sgromo ◽  
Nicholas D. Maynard ◽  
Richard S. Gillies

Abstract Background Chyle leaks following oesophagectomy are a frustrating complication of surgery with considerable morbidity. The use of near infra-red (NIR) fluorescence in surgery is an emerging technology and the use of fluorescence to identify the thoracic duct has been demonstrated in animal work and early human case reports. This study evaluated the use mesenteric and enteral administration of indocyanine green (ICG) in humans to identify the thoracic duct during oesophagectomy. Methods Patients undergoing oesophagectomy were recruited to the study. Administration of ICG via an enteral route or mesenteric injection was evaluated. Fluorescence was assessed using a NIR fluorescence enabled laparoscope system with a visual scoring system and signal to background ratios. Visualisation of the thoracic duct under white light and NIR fluorescence was compared as well as any identification of active chyle leak. Patients were followed up post-operatively for adverse events and chyle leak. Results 20 patients received ICG and were included in the study. The enteral route failed to fluoresce the thoracic duct. Mesenteric injection (17 patients) identified the thoracic duct under fluorescence prior to white light in 70% of patients with a mean signal to background ratio of 5.35. In 6 participants, a possible active chyle leak was identified under fluorescence with 4 showing active chyle leak from what was identified as the thoracic duct. Conclusion This study demonstrates that ICG administration via mesenteric injection can highlight the thoracic duct during oesophagectomy and may be a potential technology to reduce chyle leak following surgery. Clinical trial registration Clinical trials.gov (NCT03292757).


2021 ◽  
pp. 793-809
Author(s):  
Kyle A. Wilson ◽  
Bill S. Majdalany
Keyword(s):  

2021 ◽  
Vol 233 (5) ◽  
pp. e185
Author(s):  
Clara Lucato dos Santos ◽  
Laura Lucato dos Santos ◽  
Leticia N. Datrino ◽  
Guilherme Tavares ◽  
Luca S. Tristão ◽  
...  

2021 ◽  
Vol 64 (6) ◽  
pp. E650-E653
Author(s):  
Erin Williams ◽  
Nader Hanna ◽  
Ben Mussari ◽  
Wiley Chung

2021 ◽  
Author(s):  
Lucy R. Hinton ◽  
Lomani A. O'Hagan ◽  
Andrew P. Griffiths ◽  
Alys R. Clark ◽  
Anthony R. J. Phillips ◽  
...  

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Karan Gulaya ◽  
Pouya Entezari ◽  
Riad Salem ◽  
Ahsun Riaz

Abstract Background Mediastinal and abdominal lymphatic malformations may not be diagnosed until adulthood. Radiologic and pathologic diagnosis is often challenging due to the rarity of the lesion. Surgical excision of these lesions may be curative but lymphatic leak is a known complication. Lymphatic duct embolization may then be required to treat the leak. Case presentation We describe a patient with post-surgical chylothorax where thoracic duct lymphangiography and embolization was performed by catheterizing the thoracic duct at the venous angle where it drains into the subclavian vein. Conclusion Lymphatic duct embolization can be challenging in patients with lymphatic malformations. In these patients, if there is adequate visualization on ultrasound or fluoroscopy, terminal aspect of the thoracic duct can be accessed through the subclavian vein to perform the procedure.


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