HEMODYNAMIC-CHANGES AFTER RESECTION OF THORACIC-DUCT FOR EN-BLOC RESECTION OF ESOPHAGEAL CANCER
HEMODYNAMIC-CHANGES AFTER RESECTION OF THORACIC-DUCT FOR EN-BLOC RESECTION OF ESOPHAGEAL CANCER
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DOI：
10.1007/bf00308827
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发表时间：
1992-01-01
期刊：
影响因子：
--
通讯作者：
HATANO, Y
中科院分区：
文献类型：
--
作者：
IMAMURA, M;SHIMADA, Y;HATANO, Y
An en bloc resection of esophageal cancer is one of the most radical forms of esophagectomy, and includes the resection of the thoracic duct, but a relatively high hospital mortality rate has been reported. There is very little knowledge on the pathophysiological changes after resection of the thoracic duct. We examined 24 patients who underwent en bloc resection. Some patients developed severe tachycardia or shock postoperatively which subsided after a massive infusion of plasma. Analysis of the fluid balance revealed that much more fluid was necessary during surgery and the postoperative 24 h than in patients treated by a standard esophagectomy. Postoperative lymphangiography or CT revealed abnormal collateral lymphatics around the kidneys or in the pelvic cavity. This suggests the development of the lymphaticovenous shunts, which differed depending on the anatomy of each patient. One patient with chronic hepatitis developed uncontrollable ascites. These are important findings which can hopefully reduce the high rate of hospital death after this operation.
