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Surgical intervention strategy for postoperative chylothorax after lung resection

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Abstract

Purpose

The optimal surgical management of postoperative chylothorax has not been established. Thus, we evaluated the treatment strategy for postoperative chylothorax and identified associated predictors of surgical intervention.

Methods

The subjects of this retrospective study were 50 patients who suffered postoperative chylothorax, representing 4 % of 1235 patients who underwent pulmonary resection between 2008 and 2012. The chylothorax patients were classified into two groups based on their postoperative management: a conservative group and a surgical group. The following parameters were investigated to establish the predictors of surgical intervention for chylothorax: mode of surgery, preoperative complications, intraoperative management, and postoperative clinical status.

Results

Forty-one (82 %) patients were treated conservatively and 9 (18 %) underwent reoperation, as direct or concomitant ligation of the thoracic duct at the point of leakage. The frequency of postoperative chest tube drainage just after initial surgery was significantly greater in the surgical group than the conservative group before oral intake was restarted (448 ± 189 vs. 296 ± 117 ml/12 h, respectively; p = 0.003). Furthermore, it was a significant predictor of reoperation based on a multivariate analysis (p = 0.010).

Conclusions

The amount of chest tube drainage just after surgery and before oral intake was a useful predictor to help us decide on the need for early surgical intervention for postoperative chylothorax.

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Acknowledgments

This study was supported in part by a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan, and the Smoking Research Foundation.

Conflict of interest

None declared.

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Authors

Corresponding author

Correspondence to Kenji Suzuki.

Additional information

This study was presented at the 15th World Conference on Lung Cancer in Sydney, Australia, October 27–30, 2013.

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Uchida, S., Suzuki, K., Hattori, A. et al. Surgical intervention strategy for postoperative chylothorax after lung resection. Surg Today 46, 197–202 (2016). https://doi.org/10.1007/s00595-015-1183-6

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  • DOI: https://doi.org/10.1007/s00595-015-1183-6

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