Influence of thoracic duct ligation on the lipid metabolism of patients with esophageal carcinoma after esophagectomy.

The aim of this study was to determine the influence of thoracic duct ligation on the lipid metabolism of patients with esophageal carcinoma after esophagectomy. A total of 74 patients with esophageal carcinoma who underwent esophagectomy were divided into 2 groups according to whether or not their thoracic duct was ligated. Thirty-nine patients were in the thoracic duct ligation group and the other 35 assigned to the control group. Enteral feeding was through a nasojejunal tube from the 1st day to the 8th day after operation, and liquid diet was provided starting on the 6th day. We compared the plasma concentrations of cholesterol (CHOL), triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) at different time points. There were no statistically significant differences between the two groups in CHOL, TG and HDL levels at different times. However, LDL levels in the thoracic duct ligation group were significantly lower at different times compared to the other group (P < 0.05), where they were the lowest at the end of the 1st month and then gradually recovered 3 months later. Thoracic duct ligation can effectively prevent chylomicrons from being transferred to the blood, reducing the generation of LDL. The establishment of collateral circulation was slow after the ligation of the thoracic duct, which had a negative effect on early postoperative nutrition of patients.