本研究的目的是评估吲哚菁绿 (ICG) 引导淋巴造影 (ICG-Lg) 在降低食管切除术后乳糜漏 (CL) 发生率方面的有效性。乳糜胸可能严重影响食管癌手术，术前准备- 胸导管空心结扎（TD）是这种并发症最广泛的控制方法。术中 ICG-Lg 最近被嵌入微创食管切除术中，以促进 TD 检测和预先结扎。这项回顾性分析包括 2018 年 1 月至 2023 年 8 月期间在三级转诊中心因癌症接受微创 Ivor Lewis 食管切除术的连续患者。常规进行扩大淋巴结切除术并进行 TD 结扎和切除。 2021 年 1 月后接受治疗的所有患者均接受 ICG-Lg 进行 TD 识别和结扎（ICG 组），并与之前的系列（无 ICG 组）进行比较。主要结局是术后 CL 的发生率，同时采用单变量和后向逐步多变量 Logistic 回归模型来识别相关因素。纳入 320 名患者后，其中 151 名（ICG 组）在先发制人 TD 结扎前接受 ICG-Lg。除新辅助治疗（P=<0.001）和术前合并症（P=0.045）外，两组均表现出相似的特征。术中 ICG-Lg 显着降低术后 CL 的发生率（11.8% vs 4.6%，P=0.026），并且与较短的中位住院时间显着相关（13 天 vs 9 天，P=0.006）。然而，ICG-Lg 术后的 CL 更可能需要再次手术修复（P=0.050）。术中 ICG-Lg 表现出全微创食管切除术后 CL 的发生率显着降低，因此应常规纳入食管癌标准化手术技术中。食管癌大容量中心。版权所有 © 2024 Wolters Kluwer Health, Inc. 保留所有权利。

The aim of the present study is to assess the effectiveness of indocyanine-green (ICG)-guided lymphography (ICG-Lg) in reducing the incidence of chyle leak (CL) after esophagectomy.Chylothorax may severely impact esophageal cancer surgery, and the pre-emptive ligation of the thoracic duct (TD) is the most widespread control of this complication. Intraoperative ICG-Lg has been recently embedded in minimally invasive esophagectomy to facilitate TD detection and pre-emptive ligation.This retrospective analysis included consecutive patients who underwent minimally invasive Ivor Lewis esophagectomy for cancer at a tertiary referral center between January 2018 and August 2023. Patients were routinely submitted to extended lymphadenectomy with TD ligation and removal. All patients treated after January 2021 underwent ICG-Lg for TD identification and ligation (ICG group) and compared to the previous series (no-ICG group). The primary outcome was the incidence of postoperative CL, while univariate and backward stepwise multivariate logistic regression models were performed to identify associated factors.After including 320 patients, 151 (ICG group) were submitted to ICG-Lg before the pre-emptive TD ligation. Both groups presented similar characteristics, except for neoadjuvant therapy (P=<0.001) and preoperative comorbidities (P=0.045). Intraoperative ICG-Lg significantly reduced the incidence of postoperative CL (11.8% vs 4.6%, P=0.026) and was significantly associated with shorter median length of hospital stay (13 vs 9 days, P=0.006). However, CL after ICG-Lg was more likely to require repairing reoperation (P=0.050).Intraoperative ICG-Lg demonstrated significantly lower rates of CL after total minimally invasive esophagectomy and, therefore, it should be routinely embedded in the standardized surgical technique of high-volume centers for esophageal cancer.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.