Korean J Thorac Cardiovasc Surg.  2019 Dec;52(6):409-415. 10.5090/kjtcs.2019.52.6.409.

Lymphangiographic Interventions to Manage Postoperative Chylothorax

• Jeong H
• Ahn HY
• Kwon H
• Kim YD
• Cho JS
• Eom J

• KMID: 2465827
• DOI: http://doi.org/10.5090/kjtcs.2019.52.6.409

Abstract

BACKGROUND
Postoperative chylothorax may be caused by iatrogenic injury of the collateral lymphatic ducts after thoracic surgery. Although traditional treatment could be considered in most cases, resolution may be slow. Radiological interventions have recently been developed to manage postoperative chylothorax. This study aimed to compare radiological interventions and conservative management in patients with postoperative chylothorax.
METHODS
We retrospectively reviewed periprocedural drainage time, length of hospital stay, and nil per os (NPO) duration in 7 patients who received radiological interventions (intervention group [IG]) and in 9 patients who received conservative management (non-intervention group [NG]).
RESULTS
The baseline characteristics of the patients in the IG and NG were comparable; however, the median drainage time and median length of hospital stay after detection of chylothorax were significantly shorter in the IG than in the NG (6 vs. 10 days, p=0.036 and 10 vs. 20 days, p=0.025, respectively). NPO duration after chylothorax detection and total drainage duration were somewhat shorter in the IG than in the NG (5 vs. 7 days and 8 vs. 14 days, respectively).
CONCLUSION
This study showed that radiological interventions reduced the duration of drainage and the length of hospital stay, allowing an earlier return to normal life. To overcome several limitations of this study, a prospective, randomized controlled trial with a larger number of patients is recommended.

Keyword

Chylothorax; Lymphography; Postoperative care; Thoracic duct; Thoracic surgery

MeSH Terms

Chylothorax*
Drainage
Humans
Length of Stay
Lymphography
Postoperative Care
Prospective Studies
Retrospective Studies
Thoracic Duct
Thoracic Surgery