Early operative management of chylothorax by thoracic duct ligation

Chylothorax following mediastinal mobilisation for carcinoma of the oesophagus can be devastating, especially in malnourished, debilitated patients. Early surgical management in significant chylothorax (+ 500 ml/d) is suggested before nutritional degeneration occurs. Conservative management should be reserved for those patients who drain less than 500 ml/d.