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Published on: February 10, 2021
Chylothorax associated with lymphatic reflux in a thoracic duct tributary after lung cancer surgery
Hironori Ishida1, Ken Nakazawa2, Akitoshi Yanagihara1
1Department of General Thoracic Surgery, Saitama Medical University International Medical Center, Saitama, Japan.
Abstract:
Chyle leaks are attributed to damage to the thoracic duct itself or its tributaries during surgery. Chylothorax after lung cancer surgery can occur due to damaged thoracic duct tributaries; however, little is known of the mechanism involved. A 71-year-old female underwent a left upper lobectomy with hilar and mediastinal lymphadenectomy for a 1.8-cm primary squamous cell carcinoma, and developed a chylothorax a day later. Catheter lymphangiography revealed high-flow chyle leaks from a damaged thoracic duct tributary, known as a bronchomediastinal lymph trunk, due to a lymphatic reflex from the thoracic duct. Subsequently, catheter embolization of the tributary repaired the chylothorax. The potential for persistent chylothorax after lung cancer surgery and successful lymphatic intervention should be noted.
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