2019 Volume 33 Issue 5 Pages 525-531
A 61-year-old male with lung cancer of the right upper lobe was referred to our hospital. The patient underwent video-assisted thoracic surgery with right upper lobectomy+ND2a-1 and wedge resection of the right lower lobe. The drain effusion volume on postoperative day 1 (POD 1) reached 1000 mL, and the patient was diagnosed with chylothorax due to the milky drain effusion on POD 2. Conservative treatments including drainage, fasting, and total parenteral nutrition were unsuccessful, and intranodal lymphangiography (INL) was performed. Chylous discharge stopped completely on POD 10.
Postoperative chylothorax is a rare complication that can usually be treated conservatively; however, surgical intervention or another approach is required in a few cases. Since the patient had chronic obstructive pulmonary disease along with postoperative dyspnea, surgical intervention for chylothorax was not considered initially as it could have led to worsening of postoperative dyspnea. Therefore, he underwent INL, which was useful fot resolving chylothorax with a minimally invasive technique.
