case_images: PMC9115550_01
case_images: CT scan showing a uniform left massive pleural effusion.
case_images: fsurg-09-912351-g001.jpg
case_images: PMC9115550_01_fsurg-09-912351-g001.jpg
case_images: F1
case_images: Therefore, the patient was sent for an urgent chest computed tomography (CT) scan, which confirmed a massive homogeneous left effusion with contralateral mediastinal shifting (Figure 1).
case_images: PMC9115550_02
case_images: Ultrasound-guided inguinal lymph node administration of indocyanine green.
case_images: fsurg-09-912351-g002.jpg
case_images: PMC9115550_02_fsurg-09-912351-g002.jpg
case_images: F2
case_images: After general anesthesia induction, with the patient in the supine position, an ultrasound-guided inguinal lymph node injection of 10 ml saline with 0.5 mg/kg ICG solution (Infracyanine, SERB SAS, Paris, France) was bilaterally performed (Figure 2).
case_images: Left video-assisted thoracoscopic surgery (VATS) view showing fluorescent lymph spilling from the left para-aortic zone.
case_images: fsurg-09-912351-g003.jpg
case_images: PMC9115550_02_fsurg-09-912351-g003.jpg
case_images: F3
case_images: In Case 1, a dilated tributary of the TD was identified (Figure 3), while in Case 2, the leakage point was identified on the TD at the level of paraesophageal lymphadenectomy (Figure 4).
case_images: Right VATS view showing the thoracic duct and its leakage point in the low paraesophageal area.
case_images: fsurg-09-912351-g004.jpg
case_images: PMC9115550_02_fsurg-09-912351-g004.jpg
case_images: F4
case_images: In Case 1, a dilated tributary of the TD was identified (Figure 3), while in Case 2, the leakage point was identified on the TD at the level of paraesophageal lymphadenectomy (Figure 4).