Abstract:

Thoracic duct is the longest lymphatic duct in the human body and plays an important role in maintaining normal metabolism and immune function. Chylothorax is a rare complication after esophageal surgery, which is caused by the injury of the thoracic duct during esophagectomy, resulting in the accumulation of chyle in the pleural cavity. The etiology may be related to anatomical variation, patient's general condition, tumor stage, perioperative intervention and other factors. Preoperative and intraoperative preventive measures can reduce the incidence of chylothorax. Although the incidence rate is low, misdiagnosis or unsuccessful management can increase postoperative complications and lead to serious metabolic disorders and even death. Therefore, early diagnosis and intervention are of paramount importance. Diagnosis should be based on clinical manifestations, supplemented by laboratory and imaging studies. Currently, there is no standard for treatment, which mainly includes conservative treatment, interventional treatment, and surgical treatment. It is necessary to make a comprehensive judgment according to the actual situation and select the appropriate treatment method. In recent years, interventional technology could accurately localize the chylothorax, which is expected to play a more important role in the treatment of chylothorax. This article reviews the latest advances in the etiology, diagnosis, treatment, and prevention of chylothorax after esophagectomy and provides a flow chart of treatment steps to effectively manage this complication.

Key words: esophageal cancer, chylothorax, thoracic duct