Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Lymphangiographic Interventions to Manage Postoperative Chylothorax

  • Jeong, Hyuncheol (Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University Medical Research Institution) ;
  • Ahn, Hyo Yeong (Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University Medical Research Institution) ;
  • Kwon, Hoon (Department of Radiology, Pusan National University Hospital) ;
  • Kim, Yeong Dae (Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University Medical Research Institution) ;
  • Cho, Jeong Su (Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University Medical Research Institution) ;
  • Eom, Jungseop (Department of Internal Medicine, Pusan National University Hospital, Pusan National University Medical Research Institution)
  • Received : 2019.01.04
  • Accepted : 2019.06.05
  • Published : 2019.12.05
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Abstract

Background: Postoperative chylothorax may be caused by iatrogenic injury of the collateral lymphatic ducts after thoracic surgery. Although traditional treatment could be considered in most cases, resolution may be slow. Radiological interventions have recently been developed to manage postoperative chylothorax. This study aimed to compare radiological interventions and conservative management in patients with postoperative chylothorax. Methods: We retrospectively reviewed periprocedural drainage time, length of hospital stay, and nil per os (NPO) duration in 7 patients who received radiological interventions (intervention group [IG]) and in 9 patients who received conservative management (non-intervention group [NG]). Results: The baseline characteristics of the patients in the IG and NG were comparable; however, the median drainage time and median length of hospital stay after detection of chylothorax were significantly shorter in the IG than in the NG (6 vs. 10 days, p=0.036 and 10 vs. 20 days, p=0.025, respectively). NPO duration after chylothorax detection and total drainage duration were somewhat shorter in the IG than in the NG (5 vs. 7 days and 8 vs. 14 days, respectively). Conclusion: This study showed that radiological interventions reduced the duration of drainage and the length of hospital stay, allowing an earlier return to normal life. To overcome several limitations of this study, a prospective, randomized controlled trial with a larger number of patients is recommended.

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