Many thoracic surgical procedures involve excision or destruction of intrathoracic
and mediastinal lymphatics. It is widely assumed that the mediastinal lymphatic system
is surgically expendable, and that destruction of mediastinal lymphatics has no significant
adverse physiological effect. Cardiac lymphatic obstruction may give rise to cardiac
lymphedema and impaired cardiac function. Similarly, obstruction of pulmonary lymphatics
may result in pulmonary perivascular lymphedema, endothelial injury, and pulmonary
artery hypertension. This review summarizes the possible deleterious effects of intrathoracic
lymphatic destruction and the benefits of pharmacological and surgical enhancement
of active lymph drainage.
Cardiac lymphatic obstruction - Pulmonary lymphatic obstruction - Endothelial injury
- Lymphedema - Pulmonary hypertension