title: [Direct approach to the site of injury of the thoracic duct in treatment of chylothorax after pulmonary resection].
abstract: Chylothorax, a rare complication after pulmonary resection, has no single established treatment. Generally, conservative therapy is tried first, but surgery should be done without delay if chyle leakage is severe. A 73-year-old woman underwent upper left lobectomy for lung cancer. Two days later, chylothorax was diagnosed, and because chyle leakage was great, emergency re-thoracotomy was done on day 4 after the first operation. With the preoperative ingestion of 200 ml of milk and 20 g of margarine, chyle leakage from the injured thoracic duct was readily located in the upper mediastinum. Closure of the trunk of the thoracic duct may be undertaken, but a direct approach to the site of injury is more preferable, because the trunk may have collateral.
authors.affiliation: Department of Surgery, Kita Citizens' Hospital of Osaka City, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Nishiyama
authors.forename: S
authors.initials: S
authors.lastname: Nakatani
authors.forename: R
authors.initials: R
authors.lastname: Iwasa
authors.forename: S
authors.initials: S
authors.lastname: Taguchi
authors.forename: M
authors.initials: M
authors.lastname: Higashino
authors.forename: K
authors.initials: K
authors.lastname: Inoue
authors.forename: H
authors.initials: H
authors.lastname: Kinoshita
mesh_terms: D000368:Aged; D002916:Chylothorax / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000601:surgery*; D013897:Thoracic Duct / Q000293:injuries / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods