Application of fat meal in thoracic duct outlet obstruction reconstruction surgery

Abstract Background To investigate the effectiveness and safety of preoperative fat meal administration in patients undergoing thoracic duct reconstruction for chylous leakage due to thoracic duct outlet obstruction. Methods A retrospective study was conducted on 18 patients diagnosed with thoracic...

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Main Authors: Yingying Jiang, Zhichao Yao, Dayong Zhou, Zhanao Liu
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Surgery
Subjects:
Online Access:https://doi.org/10.1186/s12893-025-03113-2
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author Yingying Jiang
Zhichao Yao
Dayong Zhou
Zhanao Liu
author_facet Yingying Jiang
Zhichao Yao
Dayong Zhou
Zhanao Liu
author_sort Yingying Jiang
collection DOAJ
description Abstract Background To investigate the effectiveness and safety of preoperative fat meal administration in patients undergoing thoracic duct reconstruction for chylous leakage due to thoracic duct outlet obstruction. Methods A retrospective study was conducted on 18 patients diagnosed with thoracic duct outlet obstruction who underwent thoracic duct reconstruction between January 2022 and August 2024. Patients were administered a fat meal before surgery. The time interval between ingesting the fat meal and the exposure of the thoracic duct was recorded. Additionally, the appearance of the thoracic duct, the operating time duration, and any injuries to the thoracic duct or lymphatic branches were recorded. Results 11 patients’ thoracic ducts were exposed within 6–8 h after the fat meal, of which nine patients exhibited a milky white thoracic duct. The average surgical duration was 126.82 ± 53.30 min, and no injuries to the thoracic duct or its branches occurred in these patients. Additionally, seven patients’ thoracic ducts were exposed more than eight hours after a fat meal, among which only three patients had a milky white appearance of the thoracic duct. The average surgical duration for these patients was 180.00 ± 48.31 min ( P < 0.05), and injuries to the thoracic duct and its branches occurred in two patients. All patients achieved favourable therapeutic outcomes after thoracic duct reconstruction surgery. Conclusion Preoperative fat meals appear to enhance intraoperative visualization of the cervical segment of the thoracic duct during reconstructive surgery for thoracic duct obstruction, potentially contributing to reduced operative times and decreased incidence of iatrogenic thoracic duct injuries.
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spelling doaj-art-cb4a7b03b1bd4efc9ee66e0d44fbba892025-08-20T03:45:44ZengBMCBMC Surgery1471-24822025-08-012511810.1186/s12893-025-03113-2Application of fat meal in thoracic duct outlet obstruction reconstruction surgeryYingying Jiang0Zhichao Yao1Dayong Zhou2Zhanao Liu3Department of Operating Room, Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical UniversityDepartment of Vascular surgery, Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical UniversityDepartment of Vascular surgery, Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical UniversityDepartment of Vascular surgery, Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical UniversityAbstract Background To investigate the effectiveness and safety of preoperative fat meal administration in patients undergoing thoracic duct reconstruction for chylous leakage due to thoracic duct outlet obstruction. Methods A retrospective study was conducted on 18 patients diagnosed with thoracic duct outlet obstruction who underwent thoracic duct reconstruction between January 2022 and August 2024. Patients were administered a fat meal before surgery. The time interval between ingesting the fat meal and the exposure of the thoracic duct was recorded. Additionally, the appearance of the thoracic duct, the operating time duration, and any injuries to the thoracic duct or lymphatic branches were recorded. Results 11 patients’ thoracic ducts were exposed within 6–8 h after the fat meal, of which nine patients exhibited a milky white thoracic duct. The average surgical duration was 126.82 ± 53.30 min, and no injuries to the thoracic duct or its branches occurred in these patients. Additionally, seven patients’ thoracic ducts were exposed more than eight hours after a fat meal, among which only three patients had a milky white appearance of the thoracic duct. The average surgical duration for these patients was 180.00 ± 48.31 min ( P < 0.05), and injuries to the thoracic duct and its branches occurred in two patients. All patients achieved favourable therapeutic outcomes after thoracic duct reconstruction surgery. Conclusion Preoperative fat meals appear to enhance intraoperative visualization of the cervical segment of the thoracic duct during reconstructive surgery for thoracic duct obstruction, potentially contributing to reduced operative times and decreased incidence of iatrogenic thoracic duct injuries.https://doi.org/10.1186/s12893-025-03113-2Fat mealThoracic duct outlet obstructionChylous leakageThoracic duct reconstruction
spellingShingle Yingying Jiang
Zhichao Yao
Dayong Zhou
Zhanao Liu
Application of fat meal in thoracic duct outlet obstruction reconstruction surgery
BMC Surgery
Fat meal
Thoracic duct outlet obstruction
Chylous leakage
Thoracic duct reconstruction
title Application of fat meal in thoracic duct outlet obstruction reconstruction surgery
title_full Application of fat meal in thoracic duct outlet obstruction reconstruction surgery
title_fullStr Application of fat meal in thoracic duct outlet obstruction reconstruction surgery
title_full_unstemmed Application of fat meal in thoracic duct outlet obstruction reconstruction surgery
title_short Application of fat meal in thoracic duct outlet obstruction reconstruction surgery
title_sort application of fat meal in thoracic duct outlet obstruction reconstruction surgery
topic Fat meal
Thoracic duct outlet obstruction
Chylous leakage
Thoracic duct reconstruction
url https://doi.org/10.1186/s12893-025-03113-2
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AT zhichaoyao applicationoffatmealinthoracicductoutletobstructionreconstructionsurgery
AT dayongzhou applicationoffatmealinthoracicductoutletobstructionreconstructionsurgery
AT zhanaoliu applicationoffatmealinthoracicductoutletobstructionreconstructionsurgery