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[Postoperative Chylotholax;Intraoperative Prevention and Postoperative Management].

作者信息

Saito Tomohito, Kariya Shuji, Murakawa Tomohiro

机构信息

Department of Thoracic Surgery, Kansai Medical University, Hirakata, Japan.

出版信息

Kyobu Geka. 2017 Jul;70(8):662-667.

Abstract

Postoperative chylothorax is a relatively rare but potentially fatal complication caused by iatrogenic injury to thoracic duct system, with an incidence ranging from 2 to 4% after major lung surgery or esophagectomy. The pathophysiologic features of chylothorax include dehydration, loss of nutrients and immunological components. Intraopreative prevention is the first step for the management, and treatment options include conservative therapy, percutaneous intervention, and redo-operation. Although the treatment algorithm has not been standardized, chylothorax which is refractory to conservative treatment, or that with high output greater than 1,000 ml/day should be treated aggressively with thoracic duct embolization or redo-operation in a timely fashion. We herein review the anatomy and physiology of thoracic duct system and describe the overview of prevention and each theapeutic options of postoperative chylothorax.

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