2023 Volume 41 Issue 3 Pages 258-263
There are several reports of postoperative chylothorax from thoracic surgery field, but none from gynecologists. We report two cases of chylothorax after paraaortic lymphadenectomy of ovarian cancer.
Case 1: A 45-year-old woman underwent primary debulking surgery, including paraaortic lymphadenectomy for ovarian cancer. In the subsequent 6 days, she developed right pleural effusion and was diagnosed as chylothorax. The pleural effusion resolved with drainage and a low-fat diet within a month.
Case 2: A 44-year-old woman underwent primary debulking surgery, same as case 1. After 6 days of surgery, she developed right pleural effusion and was diagnosed chylothorax. There was no evidence of ascites. The patient was treated conservatively; drainage and fat-free intravenous nutrition. A month passed then, but the effusion did not decrease. In this case, lymphangiography was not effective to detect the leakage. With the chest tube inserted, she received adjuvant chemotherapy. Overall, it took half a year for the effusion to resolve. Postoperative chylothorax may take months to settle with conservative treatment alone.
