RSS-Feed abonnieren
DOI: 10.1055/s-2003-45423
Chylothorax: A Complication Following Lung Resection in Patients with NSCLC
Chylothorax following lung resectionPublikationsverlauf
Received April 22, 2003
Publikationsdatum:
11. Dezember 2003 (online)
![](https://www.thieme-connect.de/media/thoracic/200306/lookinside/thumbnails/10.1055-s-2003-45423-1.jpg)
Abstract
Background: Chylothorax following lung resection is not as rare as a postoperative complication as previously reported due to systematic lymph node dissection in patients undergoing lung resection for NSCLC. Methods: We retrospectively reviewed our cases that had undergone lung resection for NSCLC and investigated the frequency and outcome of chylothorax in these patients. The factors investigated were the site and type resection, technique of systematic lymph node dissection, tumour histology and disease stage. Results: Seven of 673 patients that had undergone lung resection were complicated by chylothorax (1.04 %), following lobectomy in 5 (1.28 %) and pneumonectomy in 2 (0.7 %) (p = 0.36). The fistula closed spontaneously in 5 patients between 4 - 17 days postoperatively (71 %). One of the patients in the conservative management group died on the 28th day postoperatively due to pneumonia (14 %). The remaining 2 patients underwent rethoracotomy on the 5th and 6thdays. Conclusions: These results suggest that the site of operation, type resection, and technique of systematic nodal dissection, tumour histology and disease stage do not influence the development of chylothorax in patients with NSCLC. The chylous fistula following lung resection for NSCLC tends to close spontaneously.
Key words
Chylothorax - lung resection
References
- 1 Johnstone D W, Feins R H. Chylothorax. Chest Surg Clin N Am. 1994; 4 617-612
- 2 Cevese P G, Vecchioni R, D'Amico D F, Cordino C, Biasiato R, Favia G, Fareilo G A. Postoperative Chylothorax. Six Cases in 2500 Operations, with a survey of the World Literature. J Thorac Cardiovasc Surg. 1975; 69 966-971
- 3 Goldstraw P. Report on the International Workshop in Intrathoracic Staging. Lung Cancer. 1997; 18 107-111
- 4 Mountain C F, Dresler C M. Regional Lymph Node Classification for Lung Cancer Staging. Chest. 1997; 111 1718-1723
- 5 Mountain C F. Revisions in the International System for Staging. Lung Cancer Chest. 1997; 111 1710-1717A
- 6 Staats B A, Ellefson R D, Brudahn L L, Prakash U BS, Offord K. The Lipoprotein Profile of Chylous and Nonchylous Pleural Effesions. Mayo Clinic Proc. 1980; 55 700-704
- 7 Cerfolio R J, Allen M S. Postoperative Chylothorax. J Thorac Cardiovasc Surg. 1996; 112 1361-1370
- 8 Watanabe Y. Radical Mediastinal Node Dissection. ESTS Newsletter. 1997; 1 7-13
- 9 Fahimi H, Casselman F P, Mariani M A, van Bowen W J, Knaepen P J, van Swieten H A. Current Management of Postoperative Chylothorax. Ann Thorac Surg. 2001; 71 448-450
- 10 Orringer M B, Bluett M, Deeb G M. Aggressive Treatment of Chylothorax Complicating Transhiatal Esophagectomy Without Thoracotomy. Surgery. 1988; 104 720-726
- 11 Patterson G A. Supradiaphragmatic Ligation of the Thoracic Duct in Intractable Chylous Fistula. Ann Thorac Surg. 1981; 32 44-48
- 12 Kelly R F, Shumway S J. Conservative Management of Postoperative Chylothorax Using Somatostatin. Ann Thorac Surg. 2000; 69 1944-1945
- 13 Rimensberger P C, Muller-Schenker B, Kalangos A, Begnetti M. Treatment of a Persistant Postoperative Chylothorax with Somatostatin. Ann Thorac Surg. 1998; 66 (1) 253-254
Cemal Asim Kutlu
Yedikule Hospital for Chest Disease and Chest Surgery, Istanbul, Turkey
Hakki Yeten Cad., 17/12
Sisli 80200
Istanbul
Turkey
Telefon: +90/212/296 1680
Fax: +90/212/247 4122
eMail: cakutlu@turk.net