肺癌術後乳び胸に対する無脂肪食の有用性

Assessment of Fat-free Diet for Postoperative Chylothorax

肺癌術後の乳び胸はよく知られる合併症であり，その発生頻度は2.2～2.4％1，2）とされている．乳び胸に対する治療の第一選択は保存的治療であるが，その一つとしての無脂肪食の有用性について自験例をもとに検討したので報告する．

Background：Chylothorax after lung cancer surgery is relatively rare but must be considered as a complication of thoracic surgery.

Method：Between January 2012 and June 2017, 818 patients underwent lung cancer surgery at our hospital. Among them, 14 （1.7％） patients with chylothorax were retrospectively reviewed. Three patients were treated with oral intake cessation except water and total parental nutrition （TPN）［TPN group］, 11 patients were treated with a fat-free diet （fat-free diet group）.

Results：The drainage period was similar in both group ［group TPN；13 （12～14） days and group fat-free diet；15.7 （6～42） days］. In the TPN group, 3 patients underwent pleurodesis and no patient needed surgical intervention. In the fat-free diet group, 5 patients improved only with diet management. Pleurodesis was necessary in 5 of which 3 underwent surgical intervention.

Conclusions：A fat-free diet is useful in treating chylothorax after lung cancer surgery.