High-Output Chylothorax: Novel Imaging Techniques Provide Specific Treatment.

Postesophagectomy chylothorax is a therapeutic dilemma. Understanding anatomy and leakage site is essential, although imaging techniques for thoracic lymphatics are challenging and not always available. We describe a patient with a left-sided thoracic duct and chylothorax after esophagectomy. We performed intranodal Lipiodol lymphangiography, computed tomography lymphangiography, and fluorescence-guided thoracic duct ligation with robot-assisted thoracic surgery. These techniques are useful in the postoperative setting but may also be used as preventive strategies to reduce morbidity and mortality from chylothorax after any thoracic surgery.