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THE POTENTIAL VALUE OF PROPHYLACTIC LIGATION OF THE THORACIC DUCT IN PREVENTING CHYLOUS LEAKAGE AFTER OESOPHAGECTOMY

Sultan Farraj Ahmed A. Alalshaikh

Introduction: Chylothorax is an uncommon but serious complication after esophageal resection which have a reported incidence of 0.6–4.0%. It is caused by the injury of the thoracic duct or its tributaries. Chylothorax may lead to dehydration as it may cause loss of about several liters per day, it can cause also malnutrition and immunosuppression. Unfortunately, Therapeutic approach has not been standardized yet. During primary resection of cancer esophagus, prophylactic thoracic duct ligation can decrease the incidence of chylothorax. Method: All the potentially relevant studies were chosen by a literature search in PUBMED from the year 2009 to 2019. We chose articles using PUBMED for the terms [prophylactic thoracic duct ligation]. Results: The electronic search initially resulted in 14 eligible articles. All the studies were screened by title and abstract for relevance, and subsequently, 9 irrelevant manuscripts were excluded. Next, we reviewed 5 articles which met the inclusion criteria. The sample sizes in the studies ranged between 58 and 653 patients. A total of 906 subjects were included in the 5 studies examined into the current study. Conclusion: prophylactic thoracic duct ligation after esophageal resection could be considered as an effective preventative measure to reduce the incidence of postoperative chylothorax. Key words: chylothorax – esophagectomy - prophylactic thoracic duct ligation.

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