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Updated: Aug 8, 2026
04:56
Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
Postoperative chylothorax in patients with a thoracic aortic aneurysm
Hiroya Minami1, Nobuhiko Mukohara, Tsutomu Shida
1Department of Cardiovascular Surgery, Himeji Cardiovascular Center, Himeji, Japan.
Summary
Postoperative chylothorax after thoracic aneurysm surgery is rare. Early intervention for chylous fistula management is recommended if conservative treatment fails.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Surgical Complications
Background:
- Postoperative chylothorax is an infrequent complication following thoracic aneurysm resection.
- Identifying the cause and optimizing management are crucial for patient outcomes.
Purpose of the Study:
- To investigate the causes of chylothorax after thoracic aneurysm resection.
- To evaluate the success of different management strategies for postoperative chylothorax.
Main Methods:
- A retrospective review of 4 consecutive patients (2.7% incidence) who developed chylothorax after thoracic aneurysm surgery between 2001 and 2003.
- Surgical technique involved exposing and sacrificing intercostal arteries before aneurysm incision to minimize paraplegia risk.
Main Results:
- Chylothorax was diagnosed 1.5 days postoperatively (range 1-2 days).
- Initial conservative treatment (cessation of oral intake) was successful in 50% of patients.
- The remaining 50% required surgical intervention, with complete cure achieved in all cases.
Conclusions:
- Injury to the thoracic duct or its branches during intercostal artery manipulation is a likely cause of chylothorax.
- Early surgical intervention is advised for chylothorax unresponsive to conservative management.
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