右上葉切除後に認めた遅発性乳び胸の1例

Late-onset Chylothorax after Right Upper Lobectomy；Report of a Case

はじめに　肺癌術後の乳び胸の多くは術直後に経験し，遅発性に発生することはまれである．われわれは右上葉切除から50日後に生じた遅発性乳び胸の1例を経験したので報告する．

Chylothorax after pulmonary resection is diagnosed usually within a few days after surgery, hence late-onset chylothorax is relatively rare complication. A 79-year-old woman underwent right upper lobectomy and mediastinal dissection for lung cancer. A chest tube was removed on postoperative day （POD）3, and she was discharged on POD 8. Fifty days after an operation, the patient developed a dyspnea on effort, and chest radiography revealed a right-sided pleural effusion, which we diagnosed as chylothorax. Because the treatments of a fat-free diet and subcutaneous octreotide acetate administration were ineffective, thoracic duct ligation was finally performed. The post-reoperative course was uneventful.