2011
DOI: 10.1055/s-0030-1270737 View full text |Buy / Rent full text
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Abstract: Chylothorax is a rare and serious complication of thoracic surgery and can lead to respiratory insufficiency, protein loss, fluid imbalance, and immunodeficiency. Chylothorax is often difficult and complex to manage. Although multiple approaches for the treatment of chylothorax have been reported, there is still no clear consensus on its optimal management. A surgical approach involving careful dissection and clipping of lymphatic vessels can help effectively manage chylous fistula in a majority of cases. Occa… Show more

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“…These patients with so-called refractory chylothorax are at a high risk of poor prognosis. Chemical pleurodesis, in which chemicals like talc slurry, bleomycin, and hypertonic glucose are injected into the pleural space to promote pleurodesis, has long been described as an effective technique to treat chylothorax (1,8,9). However, according to our observation, if we consider volume of pleural drainage less than 200 mL/d as the criteria of chest tube removal, there will be great variation in the required time for treatment.…”
Section: Introductionmentioning
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“…These patients with so-called refractory chylothorax are at a high risk of poor prognosis. Chemical pleurodesis, in which chemicals like talc slurry, bleomycin, and hypertonic glucose are injected into the pleural space to promote pleurodesis, has long been described as an effective technique to treat chylothorax (1,8,9). However, according to our observation, if we consider volume of pleural drainage less than 200 mL/d as the criteria of chest tube removal, there will be great variation in the required time for treatment.…”
Section: Introductionmentioning
“…Several adverse events were observed in the 34 Median follow-up (mo.) (range) 8 [3][4][5][6][7][8][9][10][11][12][13][14] patients. Electrolyte imbalance due to persistent chyle loss is reported to be very common (6) and occurred in these patients, as did chronic weakness despite normal nutritional indexes (debility of unknown origin).…”
Section: Typementioning
“…Generally, most patients are initially conservatively treated employing NPO, total parenteral nutrition, and pleural drainage [1][2][3][4]; however, an operation may be required if leakage persists for longer than 2 weeks or is greater than 1,000 mL/day for more than 5 days despite conservative therapy [1][2][3]. In such cases, bedside pleurodesis may obviate the need for surgery [5][6][7]18,19]. However, pleuritic chest pain that prevents lung rehabilitation may develop; patients may also develop a cough and be unable to take deep breaths.…”
Section: Discussionmentioning
“…23 Pleurodesis therapy using picibanil and minocycline has also been reported. 24,25 There have been several reports of successful management of LPEA using lymphangiography. LPEA could be stopped because of the inflammatory or viscous nature of the contrast agent used in lymphangiography.…”
Section: Discussionmentioning