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September - December 2004: 
Volume 17, Issue 3

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High volume lymph leakage after pulmonary parenchyma resection for lung cancer: Successful conservative management with total parenteral nutrition and octreotide.
Abstract
The experience obtained from the successful management of two recent cases of early, post-pulmonary resection, high volume lymph leakage, by the combined administration of total parenteral nutrition (TPN) and octreotide is presented. Significant lymph losses (>600 ml/24 hrs) through the chest tubes were observed the 3rd postoperative day in two male patients (74 and 50 years old), who underwent right middle and upper lobectomy and left upper lobectomy respectively for primary lung cancer. Complete cessation of oral feeding and the administration of TPN and octreotide resulted in conservative resolution of the leak within 9 and 7 days respectively. Chest tubes were removed on the 14th and the 10th postoperative day respectively, while both patients received a fat free oral diet for one month, to avoid reccurrence of the lymph leak. Post-pulmonary parenchyma resection lymph leakage can be conservatively managed by cessation of oral feeding and the combined administration of TPN and octreotide, if full expansion of the remaining lung in the operated hemithorax by efficient chest tube drainage is achieved. Pneumon 2004, 17(3):336-340.