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Eur J Cardiothorac Surg 2005;27:153-155
© 2005 Elsevier Science NL

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VATS thoracic-duct division for aortic surgery-related chylous leakage

^a Department of Cardiovascular Surgery, Tokyo Metropolitan Fuchu General Hospital, 2-9-2 Musashidai, Fuchu-shi, Tokyo 183-0042, Japan
^b Japanese Red Cross Medical Center, Tokyo, Japan

Received 29 July 2004; received in revised form 9 September 2004; accepted 17 September 2004.

^* Corresponding author. Tel.: +81 42 323 5111; fax: +81 42 323 9209. (E-mail: ootsuka-cvs{at}fuchu-hp.fuchu.tokyo.jp).

Traumatic chylothorax is a serious morbidity due to aortic surgery. We treated this complication successfully by supradiaphragmatic thoracic-duct division in five adults (three men, two women, aged 61.5±19.5 years) and a 3-year-old male infant after an average interval of 4.1±1.8 days following initial aortic surgery: graft-replacement of subclavian or descending aortic aneurysm in the adults, and correction of aortic coarctation in the infant. A right thoracoscopic approach was used in the adults and the left thoracotomy was re-used in the infant. Individual exposure and division of the thoracic duct was accomplished using an ultrasonic coagulator. The operating time was 22±5.5min for the thoracoscopy cases, and 70min for the infant. There was no mortality and no procedure-related morbidity, and chylous leakage ceased immediately in all patients. There was no recurrence of chylothorax during a mean follow-up period of 17±9.7 months. Despite our limited experience, we conclude that the present supradiaphragmatic thoracic duct division technique (right thoracoscopy in adults) is safe and perfectly effective, and therefore prompt application of this method is recommendable for treatment of aortic surgery-related traumatic chylo-leakage, particularly in vulnerable elderly or infant patients.

Key Words: Chylothorax • Thoracic duct • Aortic surgery • Thoracoscopy

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				A. Watanabe, T. Koyanagi, S. Nakashima, and T. Higami Supradiaphragmatic thoracic duct clipping for chylothorax through left-sided video-assisted thoracoscopic surgery Eur. J. Cardiothorac. Surg., February 1, 2007; 31(2): 313 - 314. [Abstract] [Full Text] [PDF]