postoperative chylothorax

postoperative chylothorax

A rare (0.5–2.0%) complication of thoracic surgery, which is characterised by milky fluid drainage, and which should be suspected in the presence of new pleural effusion and dyspnoea after thoracic surgery.

Diagnosis
Biochemistry—increased triglycerides and cytology; lymphocytosis in pleural fluid.

Morbidity
Malnutrition, dehydration, immune dysfunction; large-volume chylothorax may compromise cardiopulmonary, renal, and hepatic function.

Mortality
Up to 50%, especially if unsuspected and/or in the chronically ill.
References in periodicals archive ?
In a study comparing the incidence of postoperative chylothorax in children treated by MS or lateral thoracotomy for the correction of congenital cardiac abnormalities, both groups had an equal incidence.
2,3) The optimal management of postoperative chylothorax is controversial.
Postoperative chylothorax was confirmed by the presence of chylomicrons in the pleural effusion and triglyceride levels above 6.
Postoperative chylothorax occurred in 3 patients, all males and aged 49--64 years.
In conclusion, we propose conservative treatment of postoperative chylothorax in the first instance.
Treatment of a persistent postoperative chylothorax with somatostatin.
Octreotide for treatment of postoperative chylothorax.
Octreatide to treat postoperative chylothorax after cardiac operations in children.
12-13] In an exhaustive review of 132 cases of postoperative chylothorax in the world literature spanning 50 years, Sieczka and Harvey[14] found that the majority were related to malignant thoracic disease, with only 7 (5%) associated with benign cardiovascular procedures.
Treatment of postoperative chylothorax by fibrin glue application under thoracoscopic view with use of local anesthesia.
Thoracoscopic treatment of postoperative chylothorax after coronary bypass surgery.
Current concepts in the management of postoperative chylothorax.

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