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Ann Thorac Surg 1985;39:90-95
© 1985 The Society of Thoracic Surgeons


Articles

The Management of Chylothorax

C.L.N. Robinson, F.R.C.S., F.R.C.S.(C)

From the University of British Columbia, 808–750 W Broadway, Vancouver, BC, Canada V5Z 1H7

A series of 15 patients was treated for chylothorax over a 20-year period. The anatomy, physiology, and diseases of the thoracic duct are described, and a plan for the management of chylothorax is presented.

If conservative therapy (e.g., aspiration or drainage with restriction of oral intake and intravenous replacement) is not successful after two to three weeks, surgical treatment is necessary and efficacious. The thoracic duct is explored by a full thoracotomy on the side of the effusion. It is readily seen if 6 to 8 oz of a mixture of milk and cream is given to the patient a few hours before operation. The milky fluid drips from the open duct, which is easily oversewn.




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