Video-assisted thoracoscopic surgery in the treatment of postoperative chylothorax
Sang Gi Oh1, Ju Sik Yun1, Kook Joo Na2, Sang Yun Song2.
1Chonnam National University Hospital, Gwangju, Korea, Republic of, 2Chonnam National University Hwasun Hospital, Jeollanamdo, Korea, Republic of.
OBJECTIVE: Chylothorax is an uncommon but well-known complication following thoracic surgery. Chylothorax is usually treated conservatively, but a surgical procedure is required for cases refractory to conservative treatment. Recently, video-assisted thoracoscopic surgery (VATS) has gained popularity in the treatment of chylothorax.
METHODS: We describe 3 patients treated successfully by VATS, using 3 ports. There were 2 men aged 56 (patient 1) and 76 years (patient 2) and 1 women aged 19 years (patient 3). Bilobectomies have been performed by thoracotomy due to lung cancers in patient 1, 2. And resection of posterior mediastinal tumor have been performed by VATS in patient 3.
RESULTS: All patients were initially treated conservatively. To identify the leakage exactly, patients undergoing VATS received olive oil through a nasogastric tube 1 hour preoperatively. Patient 1 underwent direct suture of mediastinal pleura. Patient 2 underwent clipping of lymphatic vessel and ligation of thoracic duct. And Patient 3 underwent clipping of lymphatic veesel and spray of fibrin glue. All patient were discharged without recurrent chylothorax.
CONCLUSIONS: In postoperative chylothorax patients, VATS could be considered as an effective method.
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