Research Progress of Thoracic Duct Surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANGJin-zhou , ZHENXin-lin ,  ZHANGJian-hua , LIBin

Department of Thoracic Surgery, The Second Hospital, Lanzhou University, Lanzhou 730030, P.R.China;

Corresponding author：

ZHANGJian-hua, Email: 843595186@qq.com

Keywords：

Thoracic duct; Ligation; Lymphatic drainage; Research status

DOI：

10.7507/1007-4848.20160092

Video：

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Abstract Full text Figures/Tables Video References Cited by

Thoracic duct is the largest lymphatic vessel in the body. It originates from the chyle pool in the abdominal cavity, upward across aortic hiatus of the diaphragm into the right thoracic cavity, and finally importing into the left jugular vein angle. Thoracic duct plays a very important role in the transporting process of the body's lymph and chylous fluid. More than 70% of the lymph and chylous fluid transport through it into the blood. If the thoracic duct was damaged, it would lead to fluid and electrolyte imbalance, immune dysfunction, malnutrition and the patient's life would be endangered when it was serious. Therefore, the clinical significance of the thoracic duct is always a hot research issue. Through unremitting exploration in recent years, we have a further understanding about structure and function of the thoracic duct. And we used this to remould and ligate it to cure some intractable disease. Now we summarize the research progress as follows.

Citation： ZHANGJin-zhou, ZHENXin-lin, ZHANGJian-hua, LIBin. Research Progress of Thoracic Duct Surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(4): 399-402. doi: 10.7507/1007-4848.20160092 Copy

1.	Lai FC, Chen L, Tu YR, et al. Prevention of chylothorax complicating extensive espophageal resection by mass ligation of thoracic duct:a random control study. Ann Surg, 2011, 91(6): 1770-1774.
2.	Shimizu K, Yoshida J, Nishimura M, et al. Treatment strategy for chylothorax after pulmonary resection and lymph node dissection for lung cancer. J Thorac Cardiovasc Surg, 2002, 124(3): 499-502.
3.	Aiko S, Yoshizumi Y, Matsuyama T, et al. Influences of thoracic duct blockage on early enteral nutrition for patients who under went esophageal cancer surgery. JPN Thorac Cardiovasc Surg, 2003, 51(7): 263-271.
4.	张志庸, 主编. 协和胸外科学. 第2版. 北京: 科学出版社, 2010. 235.
5.	Bourgeois P, Munck D, Sales F, et al. Anomalies of thoracic lymph duct drainage demonstrated by lymphoscintigraphy and review of the literature about these anomalies. Eur J Surg Oncol, 2008, 34(5): 553-555.
6.	纪荣明, 蒋尔鹏, 申晓君, 等. 腹部手术致乳糜漏解剖学基础的研究. 中华外科杂志, 2004, 42(14): 857-860.
7.	黄琦, 江志伟, 姜军, 等. 肠外营养支持联合生长抑素治疗乳糜腹水. 肠外与肠内营养, 2003, 10(2): 74-78.
8.	Takeno A, Tamura S, Miki H, et al. Chyluria after ligation of the thoracic duct: a rare complication after thoracoscopic-assisted esophagectomy for esophageal cancer. Surg Today, 2012, 44(4): 757-760.
9.	Marcon F, Irani K, Aquino T, et al. Percutaneous treatment thoracic duct injuries. Surg Endosc, 2011, 25(9): 2844-2848.
10.	Demos NJ, Kozel J, Scerbo JE. Somatostatin in the treatment of chylothorax. Chest, 2001, 119(03): 964-966.
11.	Guo W, Zhao YP, Jiang YG, et al. Prevention of postoperative chylothorax with thoracic duct ligation during video-assisted thoracoscopic esophagectomy for cancer. Surg Endosc, 2012, 26(5): 1332-1336.
12.	Li W, Dan G, Jiang J, et al. A 2-wk conservative treatment regimen preceding thoracic duct ligation is effective and safe for treating post-esophagectomy chylothorax. J Surg Res, 2013, 185(2): 784-789.
13.	Itkin M, Kucharczuk JC, Kwak A, et al. Nonoperative thoracic duct embolizaion for traumatic duct leak:experience in 109 patients. J Thorac Cardiovasc Surg, 2010, 139(3): 584-589.
14.	Nadolski G, Itkin M. Thoracic duct embolization for the management of chylothoraces. Curr Opin Pulm Med, 2013, 19(4): 380-386.
15.	Cope C. Management of chylothorax via percutaneous embolization.Curt Opin Pulm Med, 2004, 10(4): 311-314.
16.	Hoeppner J, Hopt UT. Transabdominal mass ligation of the thoracic duct for the prevention of chylothorax following en bloc oesophagectomy. Eur J Cardiothorac Surg, 2013, 44(6): 1134-1136.
17.	Nair SK, Petko M, Hayward MP. A etiology and management of chylothorax in adults. Eur J Cardiovasc Surg, 2007, 32(2): 362-369.
18.	McGrath EE, Bcades Z, AndersonPB. Chylothorax:Aetiology, diagnosis and therapeutic options. Respir Med, 2010, 104(1): 01-08.
19.	Wemyss-Holden SA, Launois B, Maddern GJ, et al. Management of thoracic duct injuries after oesophagectomy. Br J Surg, 2001, 88(11): 1442-1448.
20.	Shackcloth M, McCarron E, Poullis M, et al. Management of thoracic duct injuries after oesophagectomy. Br J Surg, 2002, 89(6): 809.
21.	Hou X, Fu JH, Wang X, et al. Prophylactic thoracic duct ligation has unfavorable impact on overall survival in patients with resectable oesophageal cancer. Eur J Surg Oncol, 2014, 40(12): 1756-1762.
22.	Merigliano S, Molena D, Ruol A, et al. Chylothorax complicating esophagectomy for cancer:aplea for early thoracic duct ligation. J Thorac Cardiovasc Surg, 2000, 119(3): 453-457.
23.	Thompson KJ, Kernstine KH, Grannis FW, et al. Treatment of chylothorax by robotic thoracic duct ligation. Ann Thorac Surg, 2008, 85(1): 334-336.
24.	张席德, 梅懋华, 主编. 人体生理学. 第2版. 北京: 人民卫生出版社, 1987. 1569-1576.
25.	Hussain MM. Intestinal lipid absorption and lipoprotein formation. Curr Opin Lipidol, 2014, 25(3): 200-206.
26.	张永恒, 杨波, 袁真真, 等. 胸导管结扎对食管癌患者术后脂类代谢的影响. 中华全科医师杂志, 2009, 8(12): 880-883.
27.	史树堂, 何海燕, 王保芝, 等. 胸导管结扎对大鼠脂质代谢和胰组织结构的影响. 解剖学杂志, 2009, 32(6): 799-802.
28.	Zvintzou E, Skroubis G, Chroni A, et al. Effects of bariatric surgery on HDL Structure and functionality:results from a prospective trial. J Clin Lipidol, 2014, 8(4): 408-417.
29.	杨宇扬, 朱妹花, 刘宇斌, 等. 食管癌手术胸导管结扎后乳糜胸12例分析.实用医学杂志, 2004, 20(7): 794-795.
30.	Kato S, Umezawa H, Yano T, et al. Chyloptysis after ligation of the thoracic duct. Intern Med, 2012, 51(17): 2403-2406.
31.	Ohnishi H, Yamane T, Shiota N, et al. Life-threatening pulmonary lymphedema secondary to thoracic duct ligation. Interln Med, 2014, 53(20): 2341-2345.
32.	Raguse JD, Pfitzmann R, Bier J, et al. Lower-extremity lymphedema following neck dissection-an uncommon complication after cervical ligation of the thoracic duct. Oral Oncology, 2007, 43(8): 835-837.
33.	Fridental R, Fainaru M, Anavi Y, et al. The effect of neck dissection on human fat transport. Am J Otolaryngol, 2001, 22(3): 179-183.
34.	Holgate ST. Innate and adaptive immune responses in asthma. Net Med, 2012, 18(5): 673-683.
35.	Simpson JL, Brooks C, Douwes J. Innate immunity in asthma. Paediatr Respir Rev, 2008, 9(4): 263-270.
36.	Carson WF, Guernsey LA, Singh A, et al. Accumulation of regulatory T cells in local draining lymph nodes of the lung correlates with spontaneous resolution of chronic asthma in a murine model. Int Arch Allergy Immunol, 2008, 145(3): 231-243.
37.	Cao YY, Feng XB, Wang YS, et al. An increased of Th17 cell and Il-23 and Il-17 in the lymph and blood of rats with bronchial asthma. Chin J Cell Mol Immunol, 2013, 29(12): 1281-1284.
38.	Satoh E, Hattori Y, Guo L, et al. Immunosuppressive effect of long-term drainage of thoracic duct on immunological memory in adult thymectomized rats. Transpl P, 2005, 37(4): 1947-1948.
39.	Yen HH, Wee JL, Snibson KJ, et al. Thoracic duct cannulation without thoracotomy in sheep: a method for accessing efferent lymph from the lung. Vet Immunol Immunopathol, 2009, 129(1-2): 76-81.
40.	Assouad J, Riquet M, Foucault C, et al. Renal lymphatic drainage and thoracic duct connections:Implications for cancer spread. Lymphology, 2006, 39(1): 26-32.

1. Lai FC, Chen L, Tu YR, et al. Prevention of chylothorax complicating extensive espophageal resection by mass ligation of thoracic duct:a random control study. Ann Surg, 2011, 91(6): 1770-1774.
2. Shimizu K, Yoshida J, Nishimura M, et al. Treatment strategy for chylothorax after pulmonary resection and lymph node dissection for lung cancer. J Thorac Cardiovasc Surg, 2002, 124(3): 499-502.
3. Aiko S, Yoshizumi Y, Matsuyama T, et al. Influences of thoracic duct blockage on early enteral nutrition for patients who under went esophageal cancer surgery. JPN Thorac Cardiovasc Surg, 2003, 51(7): 263-271.
4. 张志庸, 主编. 协和胸外科学. 第2版. 北京: 科学出版社, 2010. 235.
5. Bourgeois P, Munck D, Sales F, et al. Anomalies of thoracic lymph duct drainage demonstrated by lymphoscintigraphy and review of the literature about these anomalies. Eur J Surg Oncol, 2008, 34(5): 553-555.
6. 纪荣明, 蒋尔鹏, 申晓君, 等. 腹部手术致乳糜漏解剖学基础的研究. 中华外科杂志, 2004, 42(14): 857-860.
7. 黄琦, 江志伟, 姜军, 等. 肠外营养支持联合生长抑素治疗乳糜腹水. 肠外与肠内营养, 2003, 10(2): 74-78.
8. Takeno A, Tamura S, Miki H, et al. Chyluria after ligation of the thoracic duct: a rare complication after thoracoscopic-assisted esophagectomy for esophageal cancer. Surg Today, 2012, 44(4): 757-760.
9. Marcon F, Irani K, Aquino T, et al. Percutaneous treatment thoracic duct injuries. Surg Endosc, 2011, 25(9): 2844-2848.
10. Demos NJ, Kozel J, Scerbo JE. Somatostatin in the treatment of chylothorax. Chest, 2001, 119(03): 964-966.
11. Guo W, Zhao YP, Jiang YG, et al. Prevention of postoperative chylothorax with thoracic duct ligation during video-assisted thoracoscopic esophagectomy for cancer. Surg Endosc, 2012, 26(5): 1332-1336.
12. Li W, Dan G, Jiang J, et al. A 2-wk conservative treatment regimen preceding thoracic duct ligation is effective and safe for treating post-esophagectomy chylothorax. J Surg Res, 2013, 185(2): 784-789.
13. Itkin M, Kucharczuk JC, Kwak A, et al. Nonoperative thoracic duct embolizaion for traumatic duct leak:experience in 109 patients. J Thorac Cardiovasc Surg, 2010, 139(3): 584-589.
14. Nadolski G, Itkin M. Thoracic duct embolization for the management of chylothoraces. Curr Opin Pulm Med, 2013, 19(4): 380-386.
15. Cope C. Management of chylothorax via percutaneous embolization.Curt Opin Pulm Med, 2004, 10(4): 311-314.
16. Hoeppner J, Hopt UT. Transabdominal mass ligation of the thoracic duct for the prevention of chylothorax following en bloc oesophagectomy. Eur J Cardiothorac Surg, 2013, 44(6): 1134-1136.
17. Nair SK, Petko M, Hayward MP. A etiology and management of chylothorax in adults. Eur J Cardiovasc Surg, 2007, 32(2): 362-369.
18. McGrath EE, Bcades Z, AndersonPB. Chylothorax:Aetiology, diagnosis and therapeutic options. Respir Med, 2010, 104(1): 01-08.
19. Wemyss-Holden SA, Launois B, Maddern GJ, et al. Management of thoracic duct injuries after oesophagectomy. Br J Surg, 2001, 88(11): 1442-1448.
20. Shackcloth M, McCarron E, Poullis M, et al. Management of thoracic duct injuries after oesophagectomy. Br J Surg, 2002, 89(6): 809.
21. Hou X, Fu JH, Wang X, et al. Prophylactic thoracic duct ligation has unfavorable impact on overall survival in patients with resectable oesophageal cancer. Eur J Surg Oncol, 2014, 40(12): 1756-1762.
22. Merigliano S, Molena D, Ruol A, et al. Chylothorax complicating esophagectomy for cancer:aplea for early thoracic duct ligation. J Thorac Cardiovasc Surg, 2000, 119(3): 453-457.
23. Thompson KJ, Kernstine KH, Grannis FW, et al. Treatment of chylothorax by robotic thoracic duct ligation. Ann Thorac Surg, 2008, 85(1): 334-336.
24. 张席德, 梅懋华, 主编. 人体生理学. 第2版. 北京: 人民卫生出版社, 1987. 1569-1576.
25. Hussain MM. Intestinal lipid absorption and lipoprotein formation. Curr Opin Lipidol, 2014, 25(3): 200-206.
26. 张永恒, 杨波, 袁真真, 等. 胸导管结扎对食管癌患者术后脂类代谢的影响. 中华全科医师杂志, 2009, 8(12): 880-883.
27. 史树堂, 何海燕, 王保芝, 等. 胸导管结扎对大鼠脂质代谢和胰组织结构的影响. 解剖学杂志, 2009, 32(6): 799-802.
28. Zvintzou E, Skroubis G, Chroni A, et al. Effects of bariatric surgery on HDL Structure and functionality:results from a prospective trial. J Clin Lipidol, 2014, 8(4): 408-417.
29. 杨宇扬, 朱妹花, 刘宇斌, 等. 食管癌手术胸导管结扎后乳糜胸12例分析.实用医学杂志, 2004, 20(7): 794-795.
30. Kato S, Umezawa H, Yano T, et al. Chyloptysis after ligation of the thoracic duct. Intern Med, 2012, 51(17): 2403-2406.
31. Ohnishi H, Yamane T, Shiota N, et al. Life-threatening pulmonary lymphedema secondary to thoracic duct ligation. Interln Med, 2014, 53(20): 2341-2345.
32. Raguse JD, Pfitzmann R, Bier J, et al. Lower-extremity lymphedema following neck dissection-an uncommon complication after cervical ligation of the thoracic duct. Oral Oncology, 2007, 43(8): 835-837.
33. Fridental R, Fainaru M, Anavi Y, et al. The effect of neck dissection on human fat transport. Am J Otolaryngol, 2001, 22(3): 179-183.
34. Holgate ST. Innate and adaptive immune responses in asthma. Net Med, 2012, 18(5): 673-683.
35. Simpson JL, Brooks C, Douwes J. Innate immunity in asthma. Paediatr Respir Rev, 2008, 9(4): 263-270.
36. Carson WF, Guernsey LA, Singh A, et al. Accumulation of regulatory T cells in local draining lymph nodes of the lung correlates with spontaneous resolution of chronic asthma in a murine model. Int Arch Allergy Immunol, 2008, 145(3): 231-243.
37. Cao YY, Feng XB, Wang YS, et al. An increased of Th17 cell and Il-23 and Il-17 in the lymph and blood of rats with bronchial asthma. Chin J Cell Mol Immunol, 2013, 29(12): 1281-1284.
38. Satoh E, Hattori Y, Guo L, et al. Immunosuppressive effect of long-term drainage of thoracic duct on immunological memory in adult thymectomized rats. Transpl P, 2005, 37(4): 1947-1948.
39. Yen HH, Wee JL, Snibson KJ, et al. Thoracic duct cannulation without thoracotomy in sheep: a method for accessing efferent lymph from the lung. Vet Immunol Immunopathol, 2009, 129(1-2): 76-81.
40. Assouad J, Riquet M, Foucault C, et al. Renal lymphatic drainage and thoracic duct connections:Implications for cancer spread. Lymphology, 2006, 39(1): 26-32.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Research Progress of Thoracic Duct Surgery

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