Successful conservative treatment of chylothorax following oesophagectomy - a clinical algorithm.

OBJECTIVES Chylothorax is an infrequent but serious complication after thoracic surgery. Optimal management is still controversial. Surgical re-interventions are associated with significant morbidity and mortality. DESIGN During a 2-year period, 3 patients developed chylothorax after oesophagectomy. This was treated conservatively, following our departmental protocol. RESULTS Conservative management (total parenteral nutrition, bowel rest, pleural drainage and octreotide, followed by a low-fat diet) was successful in all 3 cases within a reasonable period of time (14 - 18 days). CONCLUSION; We recommend conservative measures as the first-line treatment for postoperative chylothorax.