Lymphangiographic Interventions to Manage Postoperative Chylothorax

Jeong, Hyuncheol; Ahn, Hyo Yeong; Kwon, Hoon; Kim, Yeong‐Dae; Cho, Jeong Su; Eom, Jung Seop

doi:10.5090/kjtcs.2019.52.6.409

Cited by 5 publications

(1 citation statement)

References 19 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the clinical trial by Haniuda et al [ 24 ], which involved seven patients with postoperative chylothorax who had undergone pulmonary resection, six patients received successful surgical treatment after unsuccessful conservative therapy, which proved that aggressive surgical treatment is recommended for post-traumatic or post-surgical chylothorax[ 24 ]. Jeong et al [ 25 ] compared radiological interventional treatment to conservative treatment, and concluded that the former resulted in a shorter median drainage time, nil per os duration and median length of hospital stay. Unfortunately, interventional treatment is only available in a few large centers.…”

Section: Discussionmentioning

confidence: 99%

Chylothorax following posterior low lumbar fusion surgery: A case report

Huang¹,

Luo²,

Ran³

et al. 2021

WJCC

View full text Add to dashboard Cite

BACKGROUND Postoperative chylothorax is usually regarded as a complication associated with cardiothoracic surgery; however, it is one of the rare complications in orthopedic surgery. This case report describes a female patient who developed chylothorax after a successful L4-S1 transforaminal lumbar interbody fusion surgery. The etiology, diagnosis, and treatment were analyzed and discussed. CASE SUMMARY A 50-year-old woman was admitted with repeated back and leg pain. She was diagnosed with L4 degenerative spondylolisthesis, L4/L5 and L5/S1 intervertebral disc herniation and L5 instability, and underwent successful posterior L4-S1 instrumentation and fusion surgery. Unfortunately, thoracic effusion was identified 2 d after operation. The thoracic effusion was finally confirmed to be chylous based on twice positive chyle qualitative tests. The patient was discharged after 12-d persisting drainage, 3-d total parenteral nutrition and fasting, and other supportive treatments. No recurring symptoms were observed within 12 mo follow-up. CONCLUSION Differential diagnosis is crucial for unusual thoracic effusion. Comprehensive diagnosis and treatment of chylothorax are necessary. Thorough intraoperative protection to relieve high thoracic pressure caused by the prone position is important.

show abstract

Section: Discussionmentioning

confidence: 99%

Chylothorax following posterior low lumbar fusion surgery: A case report

Huang¹,

Luo²,

Ran³

et al. 2021

WJCC

View full text Add to dashboard Cite

show abstract

Chylothorax post transaxillary first rib resection for thoracic outlet syndrome

2021

View full text Add to dashboard Cite

We present a patient who developed high output chyle leak post left transaxillary first rib resection for venous thoracic outlet syndrome. The high output chylorrhoea was successfully treated by conservative measures, bed rest, parenteral nutrition and low-fat diet. The patient was discharged after an 18-day hospital stay with a complete resolution of his chylous fistula prior to discharge. This is the first documented chylothorax post transaxillary first rib resection likely due to anomalous chyle anatomy.

show abstract

Efficacy of Iopamidol for Sealing an Injured Thoracic Duct: Pilot Experiments in a Large Animal

Ahn

Song

et al. 2020

Applied Sciences

View full text Add to dashboard Cite

Chylothorax can be spontaneously healed by lymphangiography using lipiodol, but pulmonary or systemic embolization is a potential complication. We determined the efficacy of iopamidol for treating chylous leakage in an animal model. Twelve pigs were randomly divided into two groups. After inducing thoracic duct damage, pigs from groups A and B were injected with iopamidol and lipiodol, respectively. At 5, 10, and 30 min after damage induction, the drug effects were monitored by video-assisted thoracoscopy and lymphangiography. In vitro, chyle samples from the pigs were incubated with iopamidol and lipiodol. The damaged thoracic duct was harvested and examined using microscopy. In group A, four and two pigs did not show chylous leakage after 5 and 10 min, respectively. In group B, none showed chylous leakage after 5 min. Nevertheless, the p value was 0.46, and there was no statistically significant difference between groups A and B. In vitro, both iopamidol- and lipiodol-treated chyle samples adhered after 5 min and solidified at 30 min. Our findings confirmed that the damaged thoracic duct was clogged with an amorphous proteinaceous material (iopamidol). Therefore, iopamidol is potentially a new therapeutic agent for chylous leakage. Thoracic duct embolization failures or systemic embolization risks from lipiodol injection may be avoided by injecting iopamidol via the thoracic duct, and this warrants further investigation.

show abstract

Lymphangiographic Interventions to Manage Postoperative Chylothorax

Cited by 5 publications

References 19 publications

Chylothorax following posterior low lumbar fusion surgery: A case report

Chylothorax following posterior low lumbar fusion surgery: A case report

Chylothorax post transaxillary first rib resection for thoracic outlet syndrome

Efficacy of Iopamidol for Sealing an Injured Thoracic Duct: Pilot Experiments in a Large Animal

Contact Info

Product

Resources

About