[Direct approach to the site of injury of the thoracic duct in treatment of chylothorax after pulmonary resection].
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.
Nishiyama
N
N
Department of Surgery, Kita Citizens' Hospital of Osaka City, Japan.
Nakatani
S
S
Iwasa
R
R
Taguchi
S
S
Higashino
M
M
Inoue
K
K
Kinoshita
H
H
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