title: Chylothorax complicating video-assisted thoracoscopic surgery for non-small cell lung cancer.
abstract: BACKGROUND
  Chylothorax is an infrequent but well-known complication in lung cancer surgery. Previous published studies on this topic are limited, and thoracotomy has been the main surgical approach for treatment. However, chylothorax after lung cancer surgery performed solely by video-assisted thoracoscopic surgery (VATS) has rarely been investigated. The purpose of this study is to evaluate chylothorax after VATS for lung cancer.
  
  
  METHODS
  The records of 776 patients with primary non-small-cell lung cancer (NSCLC) who underwent VATS for pulmonary resection and mediastinal lymph node dissection (MLND) at our hospital from January 2010 to August 2013 were retrospectively reviewed. Twenty patients with chylothorax (2.58 %) were included in the analysis.
  
  
  RESULTS
  The 20 patients with chylothorax were all treated conservatively, but five patients (25 %) subsequently required reoperation for chylothorax. In patients with pleural drainage of less than 400 ml the first postoperative day, the chylothorax resolved with conservative treatment. Chylothorax also resolved in patients with pleural drainage of more than 400 ml the first or second postoperative day if drainage was less than 400 ml on postoperative day 4 and thereafter. Reoperations were required in cases with an increasing amount of pleural drainage on postoperative day 4 and thereafter.
  
  
  CONCLUSIONS
  Most of the chylothorax following VATS for lung cancer can be treated conservatively. However, the timing of surgical intervention for chylothorax following VATS for lung cancer can be earlier if pleural drainage does not show a trend toward decreasing with conservative treatment.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 112, Taiwan, chaoyuliu@hotmail.com.
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Liu
authors.forename: Po-Kuei
authors.initials: PK
authors.lastname: Hsu
authors.forename: Chien-Sheng
authors.initials: CS
authors.lastname: Huang
authors.forename: Yung-Han
authors.initials: YH
authors.lastname: Sun
authors.forename: Yu-Chung
authors.initials: YC
authors.lastname: Wu
authors.forename: Wen-Hu
authors.initials: WH
authors.lastname: Hsu
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D002916:Chylothorax / Q000209:etiology* / Q000628:therapy; D004322:Drainage; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008197:Lymph Node Excision / Q000009:adverse effects*; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D011184:Postoperative Period; D012086:Reoperation; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects*; D013997:Time Factors