THREE CASES OF CHYLOTHORAX POSSIBLY CAUSED BY LEAKED CHYLE FROM THE THYMUS

We experienced 3 cases of postoperative chylothorax, which might be caused by leaked chyle from excised (or dissected) site of the thymus following cervical dissection accompanied by ligation of thoracic duct, or superior mediastinal dissection including thymus excision for advanced thyroid carcinoma or recurred breast cancer. Consideration of mechanisms of the occurrence in these 3 cases provided a speculation that ligation of the thoracic duct made the internal pressure of the duct increase, a reflux of chyle to the lymphatic pathway between the thoracic duct and thymus occurred, and finally chyle leaked from the thymus to cause chylothorax. In this manner, when thymus excision (or dissection) is performed in patients whose thoracic duct was ligated at the cirvical site, careful attitude is essential to prevent leakage of chyle before it happens.In the treatment of the disease, conservative treatments such as sustained intrathoracic drainage, nutritional management through the central vein, and internal pleurodesis led to heals for all 3 cases. Conservative treatments can be recommended for such chylothorax.