Low-fat diet management strategy for chylothorax after pulmonary resection and lymph node dissection for primary lung cancer

Abstract Background: Pulmonary resection with mediastinal lymph node dissection for treating primary lung cancer could sometimes causes chylothorax as a postoperative complication. This study examined the validity of treatments for chylothorax in our hospital.Methods: We evaluated 2,019 patients who underwent lobectomy, bilobectomy, or pneumonectomy with mediastinal lymph node dissection for primary lung cancer at Shizuoka Cancer Center Hospital, Shizuoka, Japan, between September 2002 and March 2018. The diagnostic criteria for postoperative chylothorax were that the drainage from the pleural drain was evidently white and turbid, or the pleural effusion contained a triglyceride level of >110 mg/dL. The clinical courses and treatments were retrospectively reviewed.Results: Postoperative chylothorax occurred in 37 patients (1.8%), 20 men and 17 women, with a median age of 70 y (33 to 80). Thirty-five patients had a lobectomy and two patients had a bilobectomy. A low-fat diet was instituted to all patients; 35 cases improved with conservative treatment, and 2 cases required reoperation. Nine cases had a drainage volume ≥ 500 ml one day following the low-fat diet commencement, which was resolved with conservative treatment and decreased drainage was observed on the third day of treatment in seven of those cases.Conclusions: With the exception of cases with excessive drainage of ≥ 1000 mL in one day and systemic symptoms associated with chyle loss, conservative treatment could be successful even when the daily drainage volume exceeds 500 mL following a low-fat diet, provided the drainage volume decreases within three days.

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Late-onset chylothorax after pulmonary resection and systematic mediastinal lymph node dissection for lung cancer

The Japanese Journal of Thoracic and Cardiovascular Surgery ◽

10.1007/s11748-005-1007-5 ◽

2005 ◽

Vol 53 (1) ◽

pp. 39-41 ◽

Cited By ~ 7

Author(s):

Kimihiro Shimizu ◽

Yoshimi Otani ◽

Takashi Ibe ◽

Osamu Kawashima ◽

Mituhiro Kamiyoshihara ◽

...

Keyword(s):

Lung Cancer ◽

Lymph Node ◽

Lymph Node Dissection ◽

Pulmonary Resection ◽

Late Onset ◽

Mediastinal Lymph Node ◽

Mediastinal Lymph Node Dissection ◽

Node Dissection

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The evaluation of subcarinal and inferior mediastinal lymph node dissection in upper lobe primary lung cancer.

The Journal of the Japanese Association for Chest Surgery ◽

10.2995/jacsurg.11.602 ◽

1997 ◽

Vol 11 (5) ◽

pp. 602-608 ◽

Cited By ~ 1

Author(s):

Hidenori Kawasaki ◽

Kanji Nagai ◽

Junji Yoshida ◽

Mitsuyo Nishimura ◽

Kenro Takahashi ◽

...

Keyword(s):

Lung Cancer ◽

Lymph Node ◽

Lymph Node Dissection ◽

Mediastinal Lymph Node ◽

Primary Lung Cancer ◽

Mediastinal Lymph Node Dissection ◽

Node Dissection

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Treatment strategy for chylothorax after pulmonary resection and lymph node dissection for lung cancer

Journal of Thoracic and Cardiovascular Surgery ◽

10.1067/mtc.2002.124386 ◽

2002 ◽

Vol 124 (3) ◽

pp. 499-502 ◽

Cited By ~ 62

Author(s):

Kimihiro Shimizu ◽

Junji Yoshida ◽

Mituyo Nishimura ◽

Kazuya Takamochi ◽

Rie Nakahara ◽

...

Keyword(s):

Lung Cancer ◽

Lymph Node ◽

Lymph Node Dissection ◽

Treatment Strategy ◽

Pulmonary Resection ◽

Node Dissection

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Postoperative Ischemic Bronchitis After Lymph Node Dissection and Primary Lung Cancer Resection

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2010.09.021 ◽

2011 ◽

Vol 91 (2) ◽

pp. 355-359 ◽

Cited By ~ 10

Author(s):

Lotfi Benhamed ◽

Jocelyn Bellier ◽

Clément Fournier ◽

Rias Akkad ◽

Daniel Mathieu ◽

...

Keyword(s):

Lung Cancer ◽

Lymph Node ◽

Lymph Node Dissection ◽

Primary Lung Cancer ◽

Node Dissection ◽

Cancer Resection

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What are the Survival Factors in Surgically Resected Synchronous Multiple Primary Lung Cancers: A Retrospective Study

10.21203/rs.3.rs-63584/v1 ◽

2020 ◽

Author(s):

Haichao Li ◽

Kai Wang ◽

Xingxing Zhang ◽

Rong Chen ◽

Jian Zhao

Keyword(s):

Lung Cancer ◽

Lymph Node ◽

Lymph Node Dissection ◽

Primary Lung Cancer ◽

Disease Free Survival ◽

Complete Resection ◽

Postoperative Chemotherapy ◽

Node Dissection ◽

Multiple Primary ◽

Vascular Infiltration

Abstract Background: With the popularization of high-resolution computed tomography (HRCT), the detection rate of synchronous multiple primary lung cancer (SMPLC) is increasing. We retrospectively analyzed the surgical results of SMPLC patients in our hospital to determine the best treatment for SMPLC.Methods: A total of 90 SMPLC patients met the diagnostic criteria underwent complete resection and lymph node dissection or sampling without any preoperative induction therapy in the Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University. We analyzed the postoperative survival rate, and further studied the relationship between survival rates and sex, age, preoperative symptoms, tumor location, tumor number, tumor size, surgical type, surgical frequency, histopathologic types, vascular infiltration, visceral pleural invasion and postoperative therapy.Results: Among 90 patients, the 1- and 3-year disease free survival (DFS) rates were 97.0% and 76.7% while the 1- and 3-year overall survival (OS) rates were 98.81% and 82.35%. Vascular infiltration (HR=402.46, p=0.005) and postoperative chemotherapy (HR>1000, p<0.001) were independent risk factors for DFS, while only postoperative chemotherapy (HR=184.10, p=0.002) was an independent risk factor for OS.Conclusions: First, SMPLC is different from intrapulmonary metastasis and its clinical stage is also different from the 8th (2015) edition TNM classification for lung cancer. Second, when pulmonary function permits, surgery (complete resection and lymph node dissection) is a significantly beneficial treatment for patients with SMPLC. Third, for early stage SMPLC patients, vascular infiltration and postoperative chemotherapy are harmful to the survival.

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