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  • Title: [Reoperation for Chylothorax after Lung Resection].
    Author: Nakanishi K.
    Journal: Kyobu Geka; 2021 Sep; 74(10):862-866. PubMed ID: 34548460.
    Abstract:
    Chylothorax is not a rare complication of lung surgery. Diagnosis is easy in most cases, but treatment is sometimes difficult. Dietary restriction is effective in reducing the chyle but does not always cease the lymph and chyle. Two surgical procedures for postoperative chylothorax are well known:direct closure of the ruptured lymph vessel and ligation of the thoracic duct. Direct closure often fails. It is difficult to detect lymphatic leakage pre- and peri-reoperation. Early reoperation decisions are important for successful direct closure. Thoracic duct ligation is ordinarily performed using the right thoracoscopic approach because the thoracic duct runs in front of the vertebrae along the azygos vein near the diaphragm in the right pleural cavity. The effect of the ligation should be shown immediately. Unfortunately, even if the thoracic duct is confirmed to have been ligated, it sometimes fails to cease the chyle pleural effusion. This may be due to the existence or formation of lymphatic bypass routes.
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