Treatment of postoperative chylothorax with intrapleural fibrin glue

Akaogi, Eiichi; Mitsui, Kazuhiro; Sohara, Yasunori; Endo, Shunsuke; Ishikawa, Shigemi; Hori, Motokazu

doi:10.1016/0003-4975(89)90193-8

Cited by 48 publications

(17 citation statements)

References 6 publications

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“…Intravenous administration of an ␣-adrenergic drug such as etilefrin hydrochloride 19 has been shown to be capable of drying up intra-abdominal lymphatic weeping after resection of the esophagus en bloc with the thoracic duct.…”

Section: Discussionmentioning

confidence: 99%

Thoracic duct injury due to left subclavicular vein catheterization: A new conservative approach to a chyle fistula using biological glue

Anestis¹,

Farazi-Chongouki²,

Ioannis³

et al. 2012

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Thoracic duct injury due to left subclavicular vein catheterization: A new conservative approach to a chyle fistula using biological glue

Anestis¹,

Farazi-Chongouki²,

Ioannis³

et al. 2012

International Journal of Surgery Case Reports

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“…Mass ligature of the tissue in the region of the thoracic duct may also be performed with large clips. VATS can also be used for chemical pleurodesis, fibrin glue application, or high-frequency ultrasonic coagulation of the thoracic duct without clipping [27,31] and may be represent the only therapeutic option in patients who would not tolerate major surgery.…”

Section: Video-assisted Thoracic Surgery (Vats)mentioning

confidence: 99%

“…These procedures may disrupt the collateral subpleural or intercostal lymphatic network leading to an intractable chyle leak. Chemical pleurodesis or talc poudrage may be preferable, especially when a thoracic duct ligation has been performed [28][29][30][31].…”

Section: The Classic Surgical Approachmentioning

confidence: 99%

“…It is an uncommon but potentially life-threatening complication after lung resection, mediastinal surgery, and esophagectomy. There is considerable controversy concerning the management of chylothorax with some physicians favoring conservative treatment while others surgical one [2,[6][7][8][9][10][11][12][13][14][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]. Based on the reported experience with VATS thoracic duct ligation and the problems and outcome of conservative management, the guidelines regarding timing of surgery in patients with chylous leak need to be revised.…”

Section: Introductionmentioning

confidence: 99%

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Chylothorax complicating thoracic surgery: conservative or early surgical management?

2012

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Postoperative chylothorax is a rare complication in thoracic surgery. There is considerable controversy concerning the management of chylothorax with some physicians favoring conservative treatment while others favor a surgical one. Considering the current surgical experience with VATS and by reviewing the problems and outcome of conservative management, the guidelines regarding timing of surgery in patients with chylous leak need to be revised.

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“…Minimális megterhelést jelent a beteg számára a pleuraűrbe adott fi brinragasztó alkalmazása, jelenleg azonban kevés esetszám áll rendelkezésre [73].…”

Section: Sebészi Kezelésunclassified

A chylothorax modern kezelésének bizonyítékalapú áttekintése

2016

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A chylothorax napjainkban rendszerint műtéti vagy baleseti szövődmény, ritkábban daganat következménye. Prospektív vagy randomizált vizsgálatok hiányában a bizonyítékalapú kezelés személyes tapasztalaton, ideálisan a retrospektív elemzések ismeretében történik. A szerzők célja a chylothorax modern kezelésének áttekintése. A PubMed adatbázist "chylothorax" kulcsszóra szűrték az elmúlt tíz év közleményei között, kiemelve az összehasonlító értéke-léseket. A módszerek és ajánlások kritikai elemzésekor a szerzők együttes 39 éves klinikai tapasztalatukra támaszkod-tak. A konzervatív kezelés sikere az etiológiától függően nagy szórást mutat (3-90%). A non-és szemi-invazív intervenciós eljárások sikerrátája 50-100% közötti. Eredménytelen konzervatív kezeléskor a sebészi kezelés, elsősorban a ductus thoracicus lekötése jelenti a standard terápiát. Ezen beavatkozások sikerességi aránya 64-100% közötti, a morbiditási/mortalitási mutató elérheti a 25%-ot. A kezelést konzervatívan kell megkezdeni, majd egy lépcsőzetes agresszivitású terápia ajánlott, amelyben a beteg állapota és a drénvolumen irányítják a döntéshozatalt. Az intervenciós radiológiai eljárások biztonságosak, sikeresek és helyet kaptak a konzervatív és műtéti megoldások mellett. Orv. Hetil., 2016, 157(2), 43-51. Kulcsszavak: chylothorax, szövődmény, mellkassebészet Review of evidence-based modern treatment for chylothoraxChylothorax is a multi-factorial complication, frequently of an operation or an accident, but rarely of a tumour. In the absence of prospective or randomised studies evidence-based treatment is normally based on personal experience, ideally in the possession of retrospective analyses using the "best practice" method. The aim of the authors was the review the up-to-date chylothorax treatments. They performed the PubMed database's "chylothorax" keyword search of the publications reported in the last ten years. They put emphasis on articles that included a comparative analysis of the various treatment options. During the critical analysis of the methods and recommendations, the authors relied on their own joint experience amounting to 39 years. The results showed that the success of the initial conservative treatment indicates a signifi cant deviation depending on the etiology (3-90%). The success rate of noninvasive or semi-invasive interventions is between 50-100%, again depending on the etiology. The standard surgical treatment following an unsuccessful conservative treatment of an operable patient includes the fi tting of a (thoracoscopic) knot to the ductus thoracicus, pleurodesis, insertion of a permanent chest drain or a pleuroperitoneal shunt. The success rate of these interventions is between 64-100%, with a morbidity index and mortality index exceeding 25%. Conservative treatment should be the fi rst step, which should then be followed by a gradually increased aggressive therapy, during which the decisions should be made according to the patient's condition and the drain volume. Interventional radiology procedures are safe, successful an...

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Treatment of postoperative chylothorax with intrapleural fibrin glue

Cited by 48 publications

References 6 publications

Thoracic duct injury due to left subclavicular vein catheterization: A new conservative approach to a chyle fistula using biological glue

Thoracic duct injury due to left subclavicular vein catheterization: A new conservative approach to a chyle fistula using biological glue

Chylothorax complicating thoracic surgery: conservative or early surgical management?

A chylothorax modern kezelésének bizonyítékalapú áttekintése

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