Postesophagectomy Drainage of Subcarinal Collection via Mediastinoscopy
Media is any form of research output that is recorded and played. This is most commonly video, but can be audio or 3D representations.
This video demonstrates the drainage of a subcarinal collection via mediastinoscopy in a patient who had recently undergone esophagectomy. The chyle leak was localized over the gastric conduit and unsuccessfully drained percutaneously. However, computed tomography imaging showed a 4.9 mm margin inferior to the carina whereby drainage could be accomplished via mediastinoscopy.
Postoperative chylous leakage is a rare but well-documented complication of esophagectomy, with an incidence varying from 1.3-3.4% following procedures involving the thorax or the neck. Chyle leakage is a serious complication, with mortality ranging from 0 to 50%, due to significant loss of fluid, plasma protein, and immunoregulatory lymphocytes. Symptomatic patients exhibit signs of severe malnutrition, hyponatremia, acidosis, hypocalcemia, and increased susceptibility to infection.
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