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Ann Thorac Surg 1993;55:1006-1008
© 1993 The Society of Thoracic Surgeons

Articles

Postpneumonectomy chylothorax

Eric Vallieres, FRCSC, Farid M. Shamji, FRCSC, Thomas R. Todd, FRCSC*

Division of Thoracic Surgery, University of Ottawa, Ottawa Civic Hospital, Ottawa, Ontario, Canada

Accepted for publication June 16, 1992.

* Address reprint requests to Dr Todd, Ottawa Civic Hospital, 1053 Carling Ave, CPC Rm 106, Ottawa, Ont, Canada K1Y 4E9.

Chylothorax complicating pulmonary resections is exceptional and management of this complication remains controversial. We report a case of chylothorax after a right pneumonectomy and radical subcarinal nodal dissection. Successful nonoperative management consisted of controlled tube drainage, fasting, and total parenteral nutritional support for a period of 2 weeks. A review of the literature reveals 27 other cases of this complication after intrapleural pneumonectomy: 12 were treated by conservative measures alone and 15 required surgical intervention. Factors that will determine the management and the ultimate success of conservative management include (1) a relative delay in initial occurrence, (2) a decrease in or complete cessation of leakage while receiving total parenteral nutrition, and (3) favorable lymphangiographic findings.




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