Treatment of Postsurgical Chylothorax with Fibrin Glue

Yang

Asian Cardiovasc Thorac Ann

2002

Section: Discussionsupporting

confidence: 55%

Congenital Pulmonary Lymphangiectasia with Chylothorax

Yang

Asian Cardiovasc Thorac Ann

2002

“…Various agents, such as povidone-iodine (Betadine), tetracycline, talc, bleomycin, and fibrin glue, have been used in pediatric and adult patients. [81][82][83] In neonates, there are case reports of successful use of povidone-iodine 82,84 and OK-432 for pleurodesis.…”

Section: Surgical Managementmentioning

confidence: 99%

Congenital chylothorax: current perspectives and trends

Krishnamurthy

Malhotra

2017

RRN

Congenital chylothorax (CC) is the most common cause of pleural effusion in the perinatal period. The etiology is unknown in the majority of the cases. However, in some cases, it can be associated with various syndromes and genetic conditions. CC is associated with a high mortality rate. Most of the clinical manifestations are secondary to pressure effects (pulmonary hypoplasia) and loss of protein and lymphatic fluid (hydrops, malnutrition). Conservative management in the neonatal period is effective in up to 80% of cases and includes pleural drainage, parenteral nutrition/enteral medium-chain triglyceride-based formulae, and medications such as octreotide. Surgical intervention (pleurodesis, thoracic duct ligation/embolization, pleuroperitoneal shunt) may be required in persistent cases. A universal consensus on management of CC is unavailable, and data on the safety of medication use for CC in neonates are sparse.

Journal of Visceral Surgery

“…Once the wound has been localized, sutures must be made prudently in the frail inflammatory tissues. Biological glues can be useful with good results reported [34,35].…”

Section: Direct Ligaturementioning

confidence: 99%

Management of postoperative chylothorax

Rieu

Mabrut

2011

Chylothorax is a rare but severe complication of thoracic and esophageal surgery. The anatomical relations of the thoracic duct and its highly variable anatomy may explain the occurrence of thoracic duct injury during dissection of the posterior mediastinum. At an early stage, chylothorax can lead to severe cardiorespiratory and volemic complications. In case of chronicization, malnutrition and immunologic complications can occur, responsible for a mortality rate of up to 50%. Optimal management of chylothorax can decrease mortality. It is based on three options: conservative treatment, surgery and radiological treatment. Conservative treatment must be initiated at diagnosis and results in resolution of the chylothorax is achieved in 50 to 70% of cases. In case of either high flow rate chylothorax or failure of conservative treatment, reoperation is indicated. Percutaneous embolization is an interesting and minimally invasive alternative to surgery.