• Yuji Shiraishi.
• Section of Chest Surgery, Fukujuji Hospital, Kiyose, Japan.
• Kyobu Geka. 2004 Jul 1; 57 (8 Suppl): 757-61.

AbstractChylothorax is a rare complication after general thoracic surgery, but remains challenging for thoracic surgeons. Chylothorax can occur after any type of general thoracic procedures, including esophagectomy, pulmonary resection, and removal of mediastinal tumor. Unless being treated properly, chylothorax leads to high mortality. Therefore, prompt diagnosis and adequate therapy are crucial in the management of postoperative chylothorax. Chylothorax is usually discovered after a patient resumes taking fat-containing food. Milky fluid can be seen in the drainage system if a chest tube is still in place. When the diagnosis has been made, conservative treatment should be initiated at first, including cessation of oral intake and TPN. Evacuation of chylous fluid by closed chest tube drainage should also be done. A chest tube should be inserted in case the tube has already been taken out. If 10 to 14 days of conservative treatment fails, surgical treatment should be considered. Ligation or clipping of the thoracic duct itself or its tributaries is performed through open thoracotomy or video-assisted thoracoscopic (VATS) approach. The results of reoperation are usually satisfactory.

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