STUDY DESIGN: A description of the clinical picture of chylous leakage after spinal surgery. OBJECTIVES: To present the clinical course of three cases of chylous leakage after spinal surgery and to discuss the pathogenesis of the disease. SUMMARY OF BACKGROUND DATA: Chylous leakage is a rare complication after spinal surgery. It has been attributed to direct injury of a lymphatic trunk or one of its major tributaries by surgical maneuver. METHODS: Three cases of chylous leakage after circumferential thoracolumbar fusion for correction of kyphosis resulting from fracture were reported. RESULTS: All of the three cases were managed successfully; two cases of chyloretroperitoneum detected within 4 days after surgery were healed conservatively, but one case of chylothorax of which the onset was noticed 5 weeks after spinal surgery, required surgical ligation of the thoracic duct and pleurodesis. CONCLUSION: Early detection of this disease is important for a good prognosis. Retroperitoneal drainage is necessary for the detection and management of chyloretroperitoneum. The pathogenesis and management of the chylous leakage are discussed in this report.
STUDY DESIGN: A description of the clinical picture of chylous leakage after spinal surgery. OBJECTIVES: To present the clinical course of three cases of chylous leakage after spinal surgery and to discuss the pathogenesis of the disease. SUMMARY OF BACKGROUND DATA: Chylous leakage is a rare complication after spinal surgery. It has been attributed to direct injury of a lymphatic trunk or one of its major tributaries by surgical maneuver. METHODS: Three cases of chylous leakage after circumferential thoracolumbar fusion for correction of kyphosis resulting from fracture were reported. RESULTS: All of the three cases were managed successfully; two cases of chyloretroperitoneum detected within 4 days after surgery were healed conservatively, but one case of chylothorax of which the onset was noticed 5 weeks after spinal surgery, required surgical ligation of the thoracic duct and pleurodesis. CONCLUSION: Early detection of this disease is important for a good prognosis. Retroperitoneal drainage is necessary for the detection and management of chyloretroperitoneum. The pathogenesis and management of the chylous leakage are discussed in this report.
Authors: Lia Assumpcao; John L Cameron; Christopher L Wolfgang; Barish Edil; Michael A Choti; Joseph M Herman; Jean-Francois Geschwind; Kelvin Hong; Christos Georgiades; Richard D Schulick; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2008-08-07 Impact factor: 3.452