Early diagnosis and treatment of postoperative chylothorax after lung carcinoma surgery

Abstract

Objective To explore the early diagnosis and treatment of postoperative chylothorax after lung carcinoma surgery. Methods The clinical data of patients with postoperative chylothorax after lung cancer surgery from January 2009 to December 2013 were retrospectively analyzed, the difference between the video-assisted thoracoscopy surgery (VATS) and thoracotomy was compared. Results Twelve patients with postoperative chylothorax were identified among 3 479 patients who underwent lung carcinoma surgery (0.34%, 12/3 479). Proportion of postoperative chylothorax was 0.41% in VATS group (7/1 719) and 0.28% in thoracotomy group (5/1 760), the difference was not significant (P>0.05). 11 patients with postoperative chylothorax received conservative therapy, and 1 patient underwent thoracic duct ligation, all patients recovered smoothly. Comparing the VATS with the thoracotomy groups, the mean operative time was 207±29.1 min vs. 192±72.2 min, with no significant difference (P>0.05); and the average blood loss was 142.9±60.7 ml vs. 220.0±109.5 ml, with no significant difference (P>0.05). Comparing the two groups of patients data, the number of lymph node dissection: 20.1±5.7 in VATS group and 14.4±4.5 in the thoracotomy group on average, with no significant difference (P>0.05); postoperative drainage time: 13.9±4.9 days in the VATS group and 13.2±7.8 days in the thoracotomy group on average, with no significant difference (P>0.05); hospital stay: 26.7±5.7 days in the VATS group and 27.0±8.7 days in the thoracotomy group on average, with no significant difference (P>0.05). Conclusions Postoperative chylothorax is a rare complication of lung carcinoma resection. The incidence of postoperative chylothorax is not related with operation type. The prognosis is good of chylothorax by early diagnosis and effective conservative treatment. Key words: Bronchogenic carcinoma; Chylothorax; Surgery; Diagnosis/treatment