Abstract
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.
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References
Nadesan S, Ming TC, Thangaveloo G, Jasmi AY. Treatment of delayed chylothorax complicating oesophagectomy. Asian J Surg 2005;28:142–144.
Shimizu K, Yoshida J, Nishimura M, Takamochi K, Nakahara R, Nagai K. Treatment strategy for chylothorax after pulmonary resection and lymph node dissection for lung cancer. J Thorac Cardiovasc Surg 2002;124:499–502.
Shitrit D, Izbicki G, Starobin D, Aravot D, Kramer MR. Late-onset chylothorax after heart-lung transplantation. Ann Thorac Surg 2003;75:285–286.
Kutlu CA, Sayar A, Olgac G, Akin H, Olcmen A, Bedirhan MA, et al. Chylothorax: a complication following lung resection in patients with NSCLC-chylothorax following lung resection. Thorac Cardiovasc Surg 2003;51:342–345.
Kumar S, Kumar A, Pawar DK. Thoracoscopic management of thoracic duct injury: is there a place for conservatism? J Postgrad Med 2004;50:57–59.
Suemitsu R, Ondo K, Fukuyama S, Ueda H. Late-period-onset chylothorax after a pulmonary resection for lung cancer: a case report. Ann Thorac Cardiovasc Surg 2007;13:345–348.
Paes ML, Powell H. Chylothorax: an update. Br J Hosp Med 1994;51:482–490.
Okamoto H, Shoin S, Koshimura S, Shimizu R. Studies on anticancer and streptolysin S-forming abilities of hemolytic streptococci. Jpn J Microbiol 1967;11:323–336.
Shimizu J, Hayashi Y, Oda M, Morita K, Arano Y, Nagao S, et al. Treatment of postoperative chylothorax by pleurodesis with the streptococcal preparation OK-432. Thorac Cardiovasc Surg 1994;42:233–236.
Lamberts SW, Van der Lely AJ, de Herder WW, Hofland LJ. Octreotide. N Engl J Med 1996;334:246–254.
Sreedharan SP, Kodama KT, Peterson KE, Goetzl EJ. Distinct subsets of somatostatin receptors on cultured human lymphocytes. J Biol Chem 1989;264:949–952.
Shimizu K, Otani Y, Ibe T, Kawashima O, Kamiyoshihara M, Yasuo M. Late-onset chylothorax after pulmonary resection and systematic mediastinal lymph node dissection for lung cancer. Jpn J Thorac Cardiovasc Surg 2005;53:39–41.
Tokunaga T, Inoue M, Ideguchi K, Okumura M, Sawa Y. Late-onset chylothorax following extrapleural pneumonectomy for mesothelioma. Gen Thorac Cardiovasc Surg 2007;55:50–52.
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Tabu, M., Imai, K., Ogawa, Ji. et al. Late-onset chylothorax after pulmonary resection for lung cancer. Gen Thorac Cardiovasc Surg 59, 205–208 (2011). https://doi.org/10.1007/s11748-010-0635-6
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DOI: https://doi.org/10.1007/s11748-010-0635-6