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Postoperative chylothorax

R J Cerfolio1, M S Allen, C Deschamps

  • 1Section of General Thoracic Surgery, Mayo Clinic, Rochester, Minn 55905, USA.

The Journal of Thoracic and Cardiovascular Surgery
|November 1, 1996
PubMed
Summary
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Postoperative chylothorax is a rare thoracic surgery complication. Early reoperation is recommended for significant drainage or esophageal surgery, often involving thoracic duct ligation.

Area of Science:

  • Thoracic Surgery
  • Surgical Complications
  • Gastrointestinal Surgery

Background:

  • Postoperative chylothorax is an infrequent complication following general thoracic surgical procedures.
  • It occurred in 0.42% of 11,315 patients between 1987 and 1995.

Purpose of the Study:

  • To analyze the incidence, management, and outcomes of postoperative chylothorax.
  • To identify factors predicting the need for reoperation.

Main Methods:

  • Retrospective review of 47 patients with postoperative chylothorax.
  • Analysis of initial nonoperative management versus reoperation.
  • Evaluation of diagnostic tools like lymphangiography and surgical interventions such as thoracic duct ligation.

Main Results:

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  • Nonoperative management was successful in 27.7% of cases.
  • Reoperation was required in 34 patients (72.3%), with a higher rate after esophageal surgery (88.9%) compared to pulmonary resection (38.5%).
  • Thoracic duct ligation was successful in 91.2% of reoperated patients.

Conclusions:

  • Postoperative chylothorax is rare but can be serious.
  • Early reoperation is advised for persistent drainage (>1000 ml/day) or following esophageal operations.
  • Thoracic duct ligation is an effective treatment for persistent chylothorax.