Postoperative chylothorax following video-assisted mediastinoscopic lymphadenectomy (VAMLA) for early-stage non-small cell lung carcinoma

J Surg Case Rep. 2024 Oct 28;2024(10):rjae665. doi: 10.1093/jscr/rjae665. eCollection 2024 Oct.

Abstract

Chylothorax is a rare condition in which chylous fluid accumulates in the pleural cavity, most often due to iatrogenic injury of the thoracic duct. This paper reports a case of a woman in her 50s presenting with chyle leakage after a video-assisted mediastinoscopic lymphadenectomy (VAMLA) for staging of a nodule suspected of non-small cell lung carcinoma. After the VAMLA, a Uniportal Video Assisted Thoracoscopic Surgery lobectomy was scheduled during which the chylothorax was observed. The chyle was evacuated and the planned resection was conducted. The chest drain could be removed after 6 days while the patient followed a medium-chain triglyceride diet for 4 weeks. The purpose of this case report is to raise awareness for this very rare complication after VAMLA and discuss treatment options.

Keywords: chylothorax; thoracic surgery; uniportal video assisted thoracoscopic surgery; video-assisted mediastinoscopic lymphadenectomy.

Publication types

  • Case Reports