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Right arrow Esophagus - cancer

J Thorac Cardiovasc Surg 2002;124:198-199
© 2002 The American Association for Thoracic Surgery

Brief Communications

Mediastinal chyloma after esophageal cancer resection: An unusual complication causing left cardiac failure

Manuel Pera, MD, PhD, José Belda, MD, Oscar Vidal, MD, Matilde Rubio, MD, Luis Grande, MD, PhD Barcelona, Spain

From the Service of Gastrointestinal Surgery, Esophagogastric Cancer Unit, Institut de Malalties Digestives, and Institut d'Investigacions Biomèdiques August Pi I Sunyer Hospital Clinic, University of Barcelona Medical School, Barcelona, Spain.

Received for publication Dec 18, 2001. Accepted for publication Jan 11, 2002. Address for reprints: Manuel Pera, MD, PhD, Service of Gastrointestinal Surgery, Hospital Clinic, University of Barcelona Medical School, Villarroel 170, Barcelona 08036, Spain (E-mail: mpera@medicina.ub.es).

The first 20% of the full text of this article appears below.

Postoperative mediastinal chyloma is an extremely rare complication after thoracic surgery.Go Go 1,2 We report a case of a large mediastinal chyloma that developed after a seemingly successful conservative treatment for postesophagectomy chylothorax.

Clinical summary

A 51-year-old man was referred to our upper gastrointestinal surgical unit because of a 4-month history of dysphagia of solids. Endoscopy revealed an ulcerated lesion located at 25 cm from the incisors. Biopsy specimens confirmed the diagnosis of squamous cell carcinoma of the esophagus. Clinical staging resulted in the diagnosis of a locally advanced supracarinal tumor (T3-4 N1 M0). The patient received neoadjuvant multimodal therapy consisting of concurrent cisplatin and fluorouracil administration and radiation therapy. Dysphagia improved, but response evaluation demonstrated only partial response. A 3-stage esophagectomy with 2-field lymphadenectomy was performed with an esophagogastrostomy at the cervical level. Histopathologic study revealed complete pathologic response.

Oral ingestion was started on postoperative day 7, and the day after approximately 650 mL of . . . [Full Text of this Article]






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