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Successful treatment of refractory chylothorax by pedicled omentoplasty

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Abstract

A 52-year-old female with a history of past surgery for arteriovenous malformation of the thoracic spinal cord presented with left chylothorax. Lymphangiography identified diffuse lymphatic vessel (LV) growth with ectasia at the left supradiaphragmatic level. On the right side, the LVs were absent due to previous surgery. Given the ineffectiveness of conservative management, the patient required surgery. Thoracotomy showed extensive pleural fibrosis, lung atelectasis, and diffuse chyle defluxion on the parietal pleura. The diffuse chyle defluxion was not resolved by ligation. Therefore, we performed pedicled omentoplasty to fill the pleural space and to utilize its drainage and angiogenic capacity. Two years after the procedure, there was no sign of relapse. There are very few reports of refractory chylothorax successfully treated by pedicled omentoplasty. The procedure would be useful for the treatment of chylothorax when non-surgical or typical surgical management fails.

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Conflict of interest

All authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Yokohama Municipal Citizen’s Hospital, 56 Okazawa-cho Hodogaya-ku, Yokohama, Kanagawa, 240-8555, Japan

    Kazunori Kamiya, Akira Yoshizu & Toshinori Fukutomi

  2. Department of Plastic Surgery, Yokohama Municipal Citizen’s Hospital, Yokohama, Japan

    Hisashi Sakuma

  3. Department of General Surgery, Yokohama Municipal Citizen’s Hospital, Yokohama, Japan

    Taichi Yabuno

  4. Department of Respirology Medicine, Yokohama Municipal Citizen’s Hospital, Yokohama, Japan

    Akira Sato & Hiroaki Okamoto

  5. Department of Interventional Radiology, Kawasaki Saiwai Hospital, Kawasaki, Japan

    Junichi Nishimura

Authors
  1. Kazunori Kamiya
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  2. Akira Yoshizu
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  3. Toshinori Fukutomi
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  4. Hisashi Sakuma
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  5. Taichi Yabuno
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  6. Akira Sato
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  7. Hiroaki Okamoto
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  8. Junichi Nishimura
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Correspondence to Kazunori Kamiya.

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Kamiya, K., Yoshizu, A., Fukutomi, T. et al. Successful treatment of refractory chylothorax by pedicled omentoplasty. Gen Thorac Cardiovasc Surg 63, 667–669 (2015). https://doi.org/10.1007/s11748-014-0394-x

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  • DOI: https://doi.org/10.1007/s11748-014-0394-x

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