Tabu Maiko, Imai Kazuhiro, Ogawa Jun-ichi, Minamiya Yoshihiro, Yoshida Satoru, Hirayama Kyo, Sawano Takeyuki, Matsuzaki Ikuo
Department of General Thoracic Surgery, Hachinohe City Hospital, 1 Tamukai aza Bishamontaira, Hachinohe, Aomori 031-8555, Japan.
Gen Thorac Cardiovasc Surg. 2011 Mar;59(3):205-8. doi: 10.1007/s11748-010-0635-6. Epub 2011 Mar 30.
Chylothorax is a relatively rare complication of thoracic surgery. Most instances of chylothorax after pulmonary resection are diagnosed within 3 days after surgery. Hence, late-onset chylothorax is rare. A 68-year-old woman underwent right lower lobectomy and mediastinal dissection for lung cancer. After discharge, the patient developed a dry cough, and chest radiography more than 3 months after surgery revealed a right-sided pleural effusion occupying more than half of the right hemithorax, which we diagnosed as late-onset chylothorax. Treatment comprised chest drainage, subcutaneous octreotide, and pleurodesis by injecting a preparation of OK-432. Follow-up chest radiography confirmed no reaccumulation of fluid. Three months later no recurrence of pleural effusion was detected. We report a rare case of postoperative late-onset chylothorax that proved difficult to treat.
乳糜胸是胸外科手术中一种相对罕见的并发症。肺切除术后发生的乳糜胸大多在术后3天内被诊断出来。因此，迟发性乳糜胸很罕见。一名68岁女性因肺癌接受了右下肺叶切除术和纵隔淋巴结清扫术。出院后，患者出现干咳，术后3个多月的胸部X线检查显示右侧胸腔积液占据右半侧胸腔的一半以上，我们将其诊断为迟发性乳糜胸。治疗包括胸腔引流、皮下注射奥曲肽以及注射OK-432制剂进行胸膜固定术。随访胸部X线检查证实没有液体再次积聚。3个月后未检测到胸腔积液复发。我们报告了一例罕见的术后迟发性乳糜胸病例，该病例证明难以治疗。
