MANAGEMENT OF A HIGH-FLOW CHYLOTHORAX FOLLOWING L1 THORACOTOMIC CORPECTOMY: CASE REPORT

The thoracic duct and its tributaries transport the lymph into the venous system and can be damaged during anterior spine surgery because their localization in the thoracic paravertebral soft tissue. The Authors report a case of refractory and high-flow chylothorax complicating the postoperative course of a L1 corpectomy performed through a thoracotomic approach. An unexpectedly left side located thoracic duct at the thoracolumbar junction or a big tributary was probably damaged during surgery. Conservative treatment was first tried, however the chyle's leak persisted and further increased despite all medical and nutritional adopted measures (low-fat oral diet, followed by total parenteral nutrition). Hence, surgical repair was indicated and performed with excellent results. The patient improved immediately, chest tubes were removed on the fifth postoperative day and one year after surgery there are no signs of pleural effusion.