Abstract
Bilateral chylothorax is a rare complication of radical neck dissection. We experienced a case of bilateral chylothorax after neck dissection on the left side.
A 54-year-old man with pain in the mandibular gingiva was referred to our hospital from a dental clinic on 28th January 200X, and was diagnosed with squamous cell carcinoma of the left oral floor. Left radical neck dissection, right supraomohyoid neck dissection, marginal dissection of the left mandible, tumor resection of the left tongue and left oral floor, rectus abdominal free flap reconstruction, and tracheotomy were performed after preoperative chemoradiotherapy. On day 3 postoperatively, his oxygen saturation was remarkably decreased. Chest X-ray revealed bilateral pleural effusion. Pulmonary specialists were consulted and thoracic cavity drainage of the left side was performed. Biochemical analysis of the milky white effusion indicated bilateral chylothorax. On day 6 postoperatively, pleural effusion of the right thoracic cavity was increased, therefore a right thoracic drainage tube was inserted. A central venous catheter had been installed and total parenteral nutrition was initiated. Drainage from both sides of the chest decreased over the following week. As the volume of drainage fluid did not increase, the thoracic drainage tubes were removed 21 days after the operation. On day 22 postoperatively, medium-chain triglyceride diet was started. Over the five-year follow-up, the patient remains free from chylothorax.
