Ligation of thoracic duct during thoracoscopic esophagectomy can lead to decrease of T lymphocyte

Yang, Ruifeng; Liu, Tingting; Wang, Peng; Zhang, Runqi; Li, Chao; Han, Bo; Gao, Xuexin; Zhang, Lei; Jiang, Zhongmin

doi:10.4103/jcrt.jcrt_596_17

Cited by 17 publications

(19 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The thoracic regional lymph node chains can drain directly into thoracic duct 16 . As an important tube for normal lymphatic transportation, any injury or obstruction of the thoracic duct can potentially induce nutritional depletion and immune dysfunction 14,17,18 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prophylactic thoracic duct ligation is associated with poor prognosis and regional lymph node relapse in esophageal squamous cell carcinoma

Chen

Liu

Zhang

et al. 2020

Journal of Surgical Oncology

View full text Add to dashboard Cite

Objectives The ligation of thoracic duct interrupts the normal lymphatic circulation. Whether the ligation of thoracic duct would affect tumor recurrence and patient survival is unclear. Methods The correlations between prophylactic thoracic duct ligation (PLG) and prognosis were examined in patients with esophageal squamous cell carcinoma. Patients who received Ivor Lewis or McKeown esophagectomy with systemic lymph node dissection and R0 resection between 2003 and 2013 in Sun Yat‐sen University Cancer Center were included in the study. Results A total number of 473 and 462 were included in the PLG group and non‐prophylactic thoracic duct ligation (NPLG) group, respectively. The PLG group had a lower 5‐year survival rate (48.2% vs 61.6%, P < .001). After a 1:1 propensity score matching, 874 cases (437 pairs) were included and the survival analysis showed that PLG was associated with worse 5‐year cumulative survival of 48.6% vs 61.6% in those patients without ligation (P < .001). The multivariate analysis revealed that PLG was an independent factor for poor prognosis after esophagectomy (hazard ratio, HR = 1.56; 95% confidence interval, 95% CI, 1.26‐1.93, P < .001). Additionally, PLG was associated with regional lymph node relapse (P = .015). Conclusions PLG should not be performed routinely if no sign of thoracic duct rupture or tumor invasion were identified.

show abstract

Section: Discussionmentioning

confidence: 99%

“…However, only a few studies addressed this issue. Yang et al 14 reported that the ligation of thoracic duct during video‐assisted esophagectomy could trigger the decrease of CD4+ T lymphocyte in peripheral blood. Hou et al 11 found PLG was associated with poor overall survival (OS) after esophagectomy.…”

Section: Introductionmentioning

confidence: 99%

Prophylactic thoracic duct ligation is associated with poor prognosis and regional lymph node relapse in esophageal squamous cell carcinoma

Chen

Liu

Zhang

et al. 2020

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

“…Cellular immunity is indispensable in body immunity. T cell subsets are important indicators of the body immune mechanism, so it plays an important role in the diagnosis and treatment of disease and prognosis evaluation 17 . There are CD4 + and CD8 + subsets, which maintain the immune balance through mutual cooperation and restriction 18 .…”

Section: Discussionmentioning

confidence: 99%

Effect of early restrictive fluid resuscitation on inflammatory and immune factors in patients with severe pelvic fracture

La-mei

et al. 2019

Chinese Journal of Traumatology

View full text Add to dashboard Cite

PurposeTo study the effect of early restrictive fluid resuscitation (EFR) on inflammatory and immune factors in patients with severe pelvic fracture (SPF).MethodsA total of 174 SPF patients in the Department of Orthopaedics, the First Affiliated Hospital of Chengdu Medical College from July 2015 to June 2018 were involved in this study and divided into EFR group (n = 87) and control group (n = 87) using the random number table method. Conventional fluid resuscitation (CFR) was performed in control group, and EFR was performed in EFR group. The incidences of acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS) during rescue, successful rescue rate, blood transfusion volume, fluid input, and resuscitation time were compared between the two groups. The parameters including prothrombin time (PT), hematocrit (HCT), platelet (PLT) and blood lactate (BL) at the 4th hour after fluid resuscitation were recorded. The levels of inflammatory factors (TNF-α, IL-6, CRP) and immune factors (CD3+, CD4+, CD8+, CD4+/CD8+) were compared between the two groups before treatment and 7 days after treatment. The revised acute physiologic and chronic health evaluation system and the sequential organ failure assessment scores were adopted for evaluation before treatment and 7 days after treatment.ResultsThe incidences of ARDS and MODS during rescue in EFR group were significantly lower than those in control group (p=0.015 and 0.010 respectively), and the successful rescue rate in EFR group was significantly higher than that in control group (p = 0.011). The blood transfusion volume, fluid input, resuscitation time in EFR group were significantly lower than those in control group (p = 0.016, 0.002 and 0.001 respectively). At the 4th hour after fluid resuscitation, PT and BL in EFR group were significantly lower than those in control group (p = 0.021 and 0.003 respectively), while HCT and PLT in EFR group were significantly higher than those in control group (p = 0.016 and 0.021 respectively). On day 7 after treatment, TNF-α, IL-6, CRP and CD8+ in EFR group were significantly lower than those in control group (p = 0.003, 0.004, 0.007 and 0.003 respectively), while CD3+, CD4+ and CD4+/CD8+ in EFR group were significantly higher than those in control group (p = 0.004, 0.000, 0.007 respectively). On day 7 after treatment, the revised acute physiologic and chronic health evaluation (APACHE) system and the sequential organ failure assessment (SOFA) scores in EFR group were significantly lower than those in control group.ConclusionEFR can effectively eliminate inflammatory factors, improve immune function, maintain the stability of blood components, reduce the incidences of ARDS and MODS, and elevate the successful rescue rate in patients with SPF.

show abstract

“…Surgery might be the last option if the leak persists for more than 2 weeks, even with conservative treatment or a radiological intervention, or if there is a high-volume chyle leak of more than 1,000–1,500 mL/day [ 10 , 21 - 25 ].…”

Section: Treatmentmentioning

confidence: 99%

“…Surgical techniques include thoracic duct ligation, mass ligation of the tissue, pleurodesis, and pleuroperitoneal shunting [ 10 , 21 - 25 ]. Thoracic duct ligation is performed by ligating or clipping above the right diaphragm, between T8 and T12, regardless of the surgical site ( Fig.…”

Section: Treatmentmentioning

confidence: 99%

Non-conservative Management of Chylothorax

Ahn

Hoseok

2021

J Chest Surg

View full text Add to dashboard Cite

Chylothorax is caused by lymphatic leakage, which can develop after thoracic surgery and is associated with cancer. Although prospective randomized trials have not been performed, radiological interventions have been performed in several cases with persistent chylothorax, adjunct to 2 weeks of conservative management. The success rate of such interventions is diverse due to anatomical variations, although the results are promising. However, in cases of treatment failure after cycles of interventions, a team approach may be necessary to determine whether surgical management is warranted.

show abstract

Ligation of thoracic duct during thoracoscopic esophagectomy can lead to decrease of T lymphocyte

Cited by 17 publications

References 0 publications

Prophylactic thoracic duct ligation is associated with poor prognosis and regional lymph node relapse in esophageal squamous cell carcinoma

Prophylactic thoracic duct ligation is associated with poor prognosis and regional lymph node relapse in esophageal squamous cell carcinoma

Effect of early restrictive fluid resuscitation on inflammatory and immune factors in patients with severe pelvic fracture

Non-conservative Management of Chylothorax

Contact Info

Product

Resources

About