Lymphovenous anastomosis for the treatment of persistent congenital chylothorax in a low-birth-weight infant: A case report

Chylothorax remains a poorly understood phenomenon, and no optimal treatment or guidelines have been established. This is the first report of treating congenital chylothorax and lymphedema in a low-birth-weight infant by lymphovenous anastomosis (LVA). We report a case of successful LVA for persistent congenital chylothorax and lymphedema resistant to other conservative therapies. The diagnosis of chylothorax was confirmed by the predominance of lymphocytes in the pleural fluid draining from the chest tube. In addition, the infant developed oliguria and generalized lymphedema. LVA under local anesthesia combined with light sedation was performed at his medial thighs and left upper arm. Although his subcutaneous edema markedly improved, the decrease in chest tube drainage was gradual. No additional treatment was required. LVA is of considerable value as a surgical treatment option in the setting of persistent congenital chylothorax and lymphedema, because LVA is a less invasive procedure.