Video-assisted right supradiaphragmatic thoracic duct ligation for non-traumatic recurrent chylothorax

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Serval ID
serval:BIB_6B5417EB3454
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Video-assisted right supradiaphragmatic thoracic duct ligation for non-traumatic recurrent chylothorax
Journal
European Journal of Cardio-Thoracic Surgery
Author(s)
Christodoulou  M., Ris  H. B., Pezzetta  E.
ISSN
1010-7940 (Print)
Publication state
Published
Issued date
05/2006
Volume
29
Number
5
Pages
810-4
Notes
Evaluation Studies
Journal Article --- Old url value: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16626966 --- Old month value: May
Abstract
BACKGROUND: Chylothorax is an uncommon disorder with respiratory, nutritional and immunological manifestations. Surgical management is indicated in case of recurrence or failure after conservative treatment. We report our experience with video-assisted right-sided supradiaphragmatic thoracic duct ligation for non-traumatic, non-postoperative persistent or recurrent chylothorax. PATIENTS AND METHODS: The medical records of six patients operated at our institution between 1999 and 2004 were retrospectively reviewed. A right-sided chylothorax was found in four patients, a left-sided in one, and a bilateral in one. Three patients developed chylothorax after chemotherapy and chest irradiation for malignant diseases (lymphoma in two patients and breast cancer in one), one in the context of lymphangioleiomyomatosis, one due to a non-diagnosed lymphoma, and one after heart transplantation. RESULTS: The mean operative time was 102 min, with an average length of hospital stay of 14 days. Persistent cessation of chylous effusion within 7 days after surgery was observed in 5/6 patients without recurrence during a mean follow-up time of 41 months. One patient with undiagnosed mediastinal lymphoma required re-operation and thoracic duct ligation on day 8 by right-sided thoracotomy due to persistent chylothorax. No 30-day mortality was recorded. Two patients presented postoperative complications including respiratory insufficiency requiring mechanical ventilation in one, and chylous ascites development requiring peritoneo-venous LeVeen shunting in one patient. CONCLUSIONS: Recurrent or persistent non-traumatic chylothorax may be successfully treated by video-assisted right supradiaphragmatic thoracic duct ligation.
Keywords
Adult Chylothorax/etiology/*surgery Female Humans Intraoperative Period Length of Stay Ligation/adverse effects/methods Male Middle Aged Recurrence Respiratory Insufficiency/etiology/radiography Retrospective Studies Thoracic Duct/*surgery Thoracic Surgery, Video-Assisted/adverse effects/*methods
Pubmed
Web of science
Open Access
Yes
Create date
29/01/2008 13:00
Last modification date
25/09/2019 6:09
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