Abstract：
BACKGROUND: Inadvertent thoracic duct injury is common during esophagectomy and may result in postoperative chylothorax. This study\'s objective was to investigate utility of patent blue injection as a modality for intraoperative thoracic duct visualization.
METHODS: A prospective, single-arm, interventional study of patients undergoing minimally invasive esophagectomy was performed. Patients were injected with patent blue dye into both groins prior to thoracic stage of surgery and assessed for duct visualization. Control group was formed by propensity score matching using retrospectively collected data regarding patients who underwent esophagectomy.
RESULTS: A total of 25 patients were included in analysis, compared to a control of 50 patients after matching. Thoracic duct was visualized in 60% of patients in the study group (15/25 patients). Significant differences were found between study and control groups (p < 0.05) with regards to median operative time (422 vs. 285 min, respectively), overall complications (16 vs. 34%, respectively), and median postoperative length of stay (13.5 vs. 10 days, respectively). There was a difference in rate of chyle leak between study and control groups; however, this was not significant (0 vs. 12%, respectively, p = 0.17).
CONCLUSIONS: Patent blue injection represents a simple method for thoracic duct visualization during minimally invasive esophagectomy which may improve surgical outcomes.
METHODS: A prospective, single-arm, interventional study of patients undergoing minimally invasive esophagectomy was performed. Patients were injected with patent blue dye into both groins prior to thoracic stage of surgery and assessed for duct visualization. Control group was formed by propensity score matching using retrospectively collected data regarding patients who underwent esophagectomy.
RESULTS: A total of 25 patients were included in analysis, compared to a control of 50 patients after matching. Thoracic duct was visualized in 60% of patients in the study group (15/25 patients). Significant differences were found between study and control groups (p < 0.05) with regards to median operative time (422 vs. 285 min, respectively), overall complications (16 vs. 34%, respectively), and median postoperative length of stay (13.5 vs. 10 days, respectively). There was a difference in rate of chyle leak between study and control groups; however, this was not significant (0 vs. 12%, respectively, p = 0.17).
CONCLUSIONS: Patent blue injection represents a simple method for thoracic duct visualization during minimally invasive esophagectomy which may improve surgical outcomes.
摘要：
背景：意外胸导管损伤在食管切除术中很常见，可能导致术后乳糜胸。这项研究的目的是研究专利蓝注射作为术中胸导管可视化方式的实用性。
方法：前瞻性，单臂,对接受微创食管切除术的患者进行介入研究。在手术的胸部阶段之前，将患者的两个腹股沟都注射了专利蓝色染料，并进行了导管可视化评估。对照组是通过使用回顾性收集的有关食管切除术患者的数据进行倾向评分匹配而形成的。
结果：共25例患者纳入分析，与匹配后的50名患者的对照相比。研究组中60%的患者(15/25患者)可观察到胸导管。在中位手术时间（422vs.285分钟,分别)，总体并发症（16%vs.34%,分别）和中位术后住院时间（13.5vs.10天,分别)。研究组和对照组的乳糜渗漏率存在差异，然而，这并不重要(0%与12%,分别,p=0.17）。
结论：专利蓝注射是一种在微创食管癌切除术中胸导管可视化的简单方法，可以改善手术效果。
方法：前瞻性，单臂,对接受微创食管切除术的患者进行介入研究。在手术的胸部阶段之前，将患者的两个腹股沟都注射了专利蓝色染料，并进行了导管可视化评估。对照组是通过使用回顾性收集的有关食管切除术患者的数据进行倾向评分匹配而形成的。
结果：共25例患者纳入分析，与匹配后的50名患者的对照相比。研究组中60%的患者(15/25患者)可观察到胸导管。在中位手术时间（422vs.285分钟,分别)，总体并发症（16%vs.34%,分别）和中位术后住院时间（13.5vs.10天,分别)。研究组和对照组的乳糜渗漏率存在差异，然而，这并不重要(0%与12%,分别,p=0.17）。
结论：专利蓝注射是一种在微创食管癌切除术中胸导管可视化的简单方法，可以改善手术效果。
