TY - JOUR AU - Asti, Emanuele AU - Siboni, Stefano AU - Bonavina, Luigi PY - 2016 TI - Minimally invasive surgical management of chylothorax complicating esophagectomy JF - Annals of Laparoscopic and Endoscopic Surgery; Vol 1 (December 2016): Annals of Laparoscopic and Endoscopic Surgery Y2 - 2016 KW - N2 - Chylothorax is a rare complication of esophagectomy associated with increased morbidity and mortality. Prophylactic thoracic duct ligation is generally recommended during transthoracic esophagectomy, but despite this strategy chyle leak can occur. A possible explanation is that in up to 40% of individual the anatomical route of the thoracic duct is anomalous. A two-week wait and see policy with total parenteral nutrition and pleural drainage appears to be justified in patients with a chyle output of less than 1,000 mL per day. The introduction of video-assisted thoracic surgery has offered a safe and effective therapeutic alternative in these patients. We recommend primary en-bloc stapling of the thoracic duct through a right thoracoscopic approach in the semi-prone position. UR - https://ales.amegroups.org/article/view/3617