초록접수 현황
| 17F-203 | 구연 미채택시 포럼 발표 |
Management of Chyle Leakage after General Thoracic Surgery: Impact of Thoracic Duct Embolization
Dong Woog Yoon, Jong Ho Cho, Sumin Shin, Hong Kwan Kim, Yong Soo Choi, Jhingook Kim, Jae Ill Zo,Young Mog Shim
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Purpose : The aim of our study was to investigate the impact of thoracic duct embolization for the management of postoperative chylothorax.
Methods : From Jan 2015 to June 2017, We retrospectively reviewed patients who had postoperative chylothorax. Since May 2016, thoracic duct embolization (TDE) has been introduced in our hospital. According to this, we divided into two group: the first period (Jan 2015 ~ Apr 2016, N=57) and second period (May 2016 ~ June 2017, N=48). The incidence of chylothorax and subsequent therapeutic management was reviewed.
Results : Chylothorax after surgery was observed in 105 patients (2.5%). Treatment consisted of low-fat diet in 19 %, TPN in 59 % surgery in 8.6%, and TDE in 9.5%. TDE was tried in 15 patients but successful in 10 patients, consisting 5 of 6 in lung cancer, and 5 of 9 in esophageal cancer.
In the first period (n=57), 6 patients (10.5%) underwent thoracic duct ligation. However, only 3 patients (6.2%) underwent thoracic duct ligation in the second period (n=48). For the subgroup analysis by disease, the mean length of stay for the first period of the lung cancer group was statistically significantly lower than the number of days for the second period (12.6 vs 16.3 days, p=0.026) but there was no difference in the esophageal patient group (26.8 vs 35.9, p=0.302).
Conclusion : TDE is an effective method for the management of chylothorax. It might be less effective in esophageal cancer surgery than in the case of chylothorax after lung cancer surgery.
Methods : From Jan 2015 to June 2017, We retrospectively reviewed patients who had postoperative chylothorax. Since May 2016, thoracic duct embolization (TDE) has been introduced in our hospital. According to this, we divided into two group: the first period (Jan 2015 ~ Apr 2016, N=57) and second period (May 2016 ~ June 2017, N=48). The incidence of chylothorax and subsequent therapeutic management was reviewed.
Results : Chylothorax after surgery was observed in 105 patients (2.5%). Treatment consisted of low-fat diet in 19 %, TPN in 59 % surgery in 8.6%, and TDE in 9.5%. TDE was tried in 15 patients but successful in 10 patients, consisting 5 of 6 in lung cancer, and 5 of 9 in esophageal cancer.
In the first period (n=57), 6 patients (10.5%) underwent thoracic duct ligation. However, only 3 patients (6.2%) underwent thoracic duct ligation in the second period (n=48). For the subgroup analysis by disease, the mean length of stay for the first period of the lung cancer group was statistically significantly lower than the number of days for the second period (12.6 vs 16.3 days, p=0.026) but there was no difference in the esophageal patient group (26.8 vs 35.9, p=0.302).
Conclusion : TDE is an effective method for the management of chylothorax. It might be less effective in esophageal cancer surgery than in the case of chylothorax after lung cancer surgery.
책임저자: Jong Ho Cho
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
발표자: Jong Ho Cho, E-mail : jongho.cho@gmail.com