Early thoracic duct ligation for postoperative chylothorax. 1996

E M Sieczka, and J C Harvey
Department of General Surgery, Beth Israel Medical Center, New York, New York, USA.

Four cases of postoperative chylothorax occurring at this institution over the past 5 years, as well as an extensive review of the world literature, are presented. Of the four cases, three occurred after resection of carcinoma of the lung and one after resection of recurrent chondrosarcoma of the chest wall. These patients were treated nonoperatively for varying periods of time ranging from 2 days to nearly 3 weeks. Subsequently, all patients underwent ligation of the thoracic duct. Early reoperation for ligation of the thoracic duct resulted in no morbidity or mortality. In one case of delayed thoracic duct ligation, after an attempt at ligation of minor lymphatic vessels, the single mortality occurred. In view of the experience with these patients and that reported in the literature, we propose that not only is thoracic duct ligation superior to nonoperative management, but that it should be undertaken without delay.

UI MeSH Term Description Entries
D008026 Ligation Application of a ligature to tie a vessel or strangulate a part. Ligature,Ligations,Ligatures
D008175 Lung Neoplasms Tumors or cancer of the LUNG. Cancer of Lung,Lung Cancer,Pulmonary Cancer,Pulmonary Neoplasms,Cancer of the Lung,Neoplasms, Lung,Neoplasms, Pulmonary,Cancer, Lung,Cancer, Pulmonary,Cancers, Lung,Cancers, Pulmonary,Lung Cancers,Lung Neoplasm,Neoplasm, Lung,Neoplasm, Pulmonary,Pulmonary Cancers,Pulmonary Neoplasm
D008197 Lymph Node Excision Surgical excision of one or more lymph nodes. Its most common use is in cancer surgery. (From Dorland, 28th ed, p966) Lymph Node Dissection,Lymphadenectomy,Dissection, Lymph Node,Dissections, Lymph Node,Excision, Lymph Node,Excisions, Lymph Node,Lymph Node Dissections,Lymph Node Excisions,Lymphadenectomies,Node Dissection, Lymph,Node Dissections, Lymph
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011013 Pneumonectomy The excision of lung tissue including partial or total lung lobectomy. Bronchoscopic Lung Volume Reduction,Endoscopic Lung Volume Reduction,Lung Volume Reduction,Lung Volume Reduction Surgery,Partial Pneumonectomy,Partial Pneumonectomies,Pneumonectomies,Pneumonectomy, Partial,Reduction, Lung Volume,Volume Reduction, Lung
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D002813 Chondrosarcoma A slowly growing malignant neoplasm derived from cartilage cells, occurring most frequently in pelvic bones or near the ends of long bones, in middle-aged and old people. Most chondrosarcomas arise de novo, but some may develop in a preexisting benign cartilaginous lesion or in patients with ENCHONDROMATOSIS. (Stedman, 25th ed) Chondrosarcomas
D002916 Chylothorax The presence of chyle in the thoracic cavity. (Dorland, 27th ed)

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