Chylous cardiac tamponade after single-port VATS lobectomy in NSCLC

Chylothorax is the accumulation of chyle in the pleural space. The primary cause of chylothorax is injury to the thoracic duct, through which chyle travels to the subclavian vein. Cardiothoracic surgery is a main cause of traumatic chylothorax. If left untreated, chylothorax may prove dangerous for patients. Chylous pericardial effusion carries a higher risk of fatality than chylothorax and can lead to life-threatening cardiac tamponade. Emergency treatment should be carried out. However, there is no effective drainage method for chylous pericardial effusion after thoracic surgery. Here, we report a case of chylous cardiac tamponade after lobectomy with mediastinal lymph node (LN) dissection in non-small-cell lung cancer. A patient visited our emergency room (ER) for dyspnea with a large amount of pleural and pericardial effusion. He had received lobectomy for lung cancer 1 month previously. Pleural effusion evaluation showed that chylothorax and chylous pericardial tamponade had developed during conservative care. The patient underwent thoracic duct ligation and was discharged without any sequela in the following 4 months. This case indicates that thoracic duct ligation could provide effective treatment for patients with both chylothorax and chylous pericardial tamponade.