@article{oai:air.repo.nii.ac.jp:00005416,
 author = {Maruyama, Kiyotomi and Shimada, Kou and Hamanaka, Toshikazu and Sugenoya, Shinsuke and Gomi, Kuniyuki and Mihara, Motohiro and Kajikawa, Shoji and Sato, Yusuke},
 journal = {International Journal of Surgery Case Reports},
 month = {},
 note = {INTRODUCTION: We debate whether or not to approach from right thorax for the left chylothorax afteresophagectomy.PRESENTATION OF CASE: A 50 s-year-old female underwent right-sided thoracoscopic esophagectomywith three-field lymphadenectomy for esophageal carcinoma (type 0-IIa, 3.4 × 2.2 cm, T1bN0M0, StageIA), followed by reconstruction with esophagogastric anastomosis through the posterior mediastinum.The thoracic duct was excised and ligated. The left thoracic drainage increased to 2115 mL/day on thefifth postoperative day. Thoracic duct injury was diagnosed, and surgery was performed on sixth post-operative day. With the patient in a prone position, the thoracic duct was ligated successfully underthoracoscopy in the left thorax. The leakage point was found in the crushed duct by 8.8-mm tita-nium clips. Then, we performed mass ligation of the thoracic duct with 11-mm titanium clips belowthe leakage point after careful dissection. The surgery took 58 min, with an estimated total blood lossof 0 g.DISCUSSION: Although thoracic duct is anatomically located on the right side of the descending aorta,we employed a left-sided thoracoscopic approach due to the chylous leakage in the left thorax. With thepatient in the prone position, surgeons can easily convert from a left thoracic approach to a right thoracicapproach immediately without postural change if the thoracic duct cannot be found in the left thoraciccavity.CONCLUSION: This technique is useful and should be considered for patients with left chylothorax.},
 pages = {247--250},
 title = {A left thoracic approach in a prone position for thoracoscopic thoracic duct ligation in a patient with post-esophagectomy chylothorax: A case report},
 volume = {41},
 year = {2017}
}