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Chylous pericardial effusion after pulmonary lobectomy
Weixiong Yang1, Canqiao Luo2, Zhenguo Liu1
1Department of Thoracic Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Interactive Cardiovascular and Thoracic Surgery
|March 23, 2017
Summary
Chylous pericardial effusion is a rare complication following lung cancer surgery. Surgical ligation of the thoracic duct and pericardial fenestration successfully treated a case in an elderly man.
Area of Science:
- Cardiothoracic Surgery
- Thoracic Oncology
- Gastroenterology
Background:
- Chylous pericardial effusion is an uncommon complication after thoracic surgery, particularly lung cancer resection.
- The lymphatic system's integrity can be compromised during extensive thoracic procedures, leading to chyle leakage.
Observation:
- An elderly male patient developed recurrent chylous pericardial effusion post-right upper lung resection for cancer.
- The effusion initially presented in the pericardium, migrated to the right chest, and returned to the pericardium.
- Lymphoscintigraphy identified a chylous fistula near the tracheal carina.
Findings:
- Conservative management failed to resolve the chylous effusion.
- Video-assisted thoracic surgery (VATS) with thoracic duct ligation and pericardial fenestration proved effective.
- The patient was discharged with no recurrence of the effusion.
Implications:
- This case highlights the complex management of chylous pericardial effusion after lung cancer surgery.
- Understanding the potential mechanisms and early surgical intervention may improve patient outcomes.
- Further strategies for prevention of postoperative chylous pericardial effusion are warranted.
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