Impact of Enhanced Chest CT with three-dimensional Reconstruction Combined with Preoperative Olive Oil Administration on the Incidence of Postoperative Chylothorax: A Retrospective Study

Background Chylothorax, a rare yet potentially fatal complication, may arise following esophageal cancer resection. The objective of this study is to assess the effectiveness of a combined approach involving enhanced chest CT with three-dimensional(3D) reconstruction and preoperative olive oil administration in mitigating the risk of chylothorax after esophageal cancer surgery. Methods A retrospective analysis was performed on the clinical records of 357 patients who underwent esophageal cancer resection at the Department of Thoracic Surgery, Gansu Provincial People's Hospital, between January 2019 and June 2024. The patients were divided into two groups: 179 received preoperative enhanced chest CT with 3D reconstruction and oral olive oil (3D reconstruction Group), while 158 served as the control group without these interventions. The primary endpoints included the incidence of chylous leakage and associated perioperative outcomes. Results All patients in both groups had successful surgeries without any perioperative fatalities. Notably, the 3D reconstruction Group exhibited a significantly lower incidence of postoperative chylothorax compared to the control group (0% vs. 8.2%, P ≤ 0.001). Furthermore, the 3D reconstruction Group experienced reduced intraoperative bleeding (P = 0.003), shorter postoperative hospital stays (P = 0.003), and decreased thoracic drainage on the third postoperative day (P < 0.001). Conclusion The integration of preoperative enhanced CT with 3D reconstruction and oral olive oil administration facilitates personalized surgical planning for esophageal cancer resection. This approach enhances the visualization of the thoracic duct during surgery and effectively reduces the incidence of postoperative chylothorax, highlighting its promising clinical utility.