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Article: Chylothorax in Children After Congenital Heart Surgery
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TitleChylothorax in Children After Congenital Heart Surgery
 
AuthorsChan, Sy1
Lau, W1
Wong, WHS1
Cheng, Lc1
Chau, AKT1
Cheung, Yf1
 
Issue Date2006
 
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsur
 
CitationAnnals Of Thoracic Surgery, 2006, v. 82 n. 5, p. 1650-1656 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.athoracsur.2006.05.116
 
AbstractBackground: A definitive management strategy for postoperative chylothorax remains elusive. We reviewed our experience in the management of chylothorax in children after congenital heart surgery. Methods: The case records of 51 patients, with a median age of 11 months (range, 4 days to 19.6 years), diagnosed to have postoperative chylothorax between 1981 and 2004 were reviewed. The responses of patients to nutritional modifications, octreotide therapy, and surgical interventions were noted. Results: The prevalence of postoperative chylothorax, which developed at a median of 9 days after operation (range, 0 to 24 days), was 0.85% (51 of 5,995). Four patients died, and among the 47 survivors the median duration and total volume of chylous drainage was 15 days (range, 1 to 89 days) and 156 mL/kg (range, 3 to 6,476), respectively. The duration of chyle output was significantly longer after the Fontan-type procedures (p = 0.0006). Twenty-one patients were diagnosed between 1981 and 1999 and managed by nutritional modifications, 2 of whom required further surgical interventions. Of the 30 patients diagnosed between 2000 and 2004, 12 responded to nutritional modifications alone while 18 were started on octreotide therapy at a median of 19.5 days (range, 7 to 35 days) after the onset of chylothorax. Fifteen of the 18 (83%) patients responded to octreotide therapy at 15.3 ± 5.5 days after starting octreotide, while 3 required further surgical interventions. None developed side effects from octreotide therapy. Conclusions: Octreotide has been incorporated into the management algorithm of postoperative chylothorax and appears to be a useful adjunctive therapy. © 2006 The Society of Thoracic Surgeons.
 
ISSN0003-4975
2012 Impact Factor: 3.454
2012 SCImago Journal Rankings: 1.404
 
DOIhttp://dx.doi.org/10.1016/j.athoracsur.2006.05.116
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorChan, Sy
 
dc.contributor.authorLau, W
 
dc.contributor.authorWong, WHS
 
dc.contributor.authorCheng, Lc
 
dc.contributor.authorChau, AKT
 
dc.contributor.authorCheung, Yf
 
dc.date.accessioned2012-10-30T06:07:54Z
 
dc.date.available2012-10-30T06:07:54Z
 
dc.date.issued2006
 
dc.description.abstractBackground: A definitive management strategy for postoperative chylothorax remains elusive. We reviewed our experience in the management of chylothorax in children after congenital heart surgery. Methods: The case records of 51 patients, with a median age of 11 months (range, 4 days to 19.6 years), diagnosed to have postoperative chylothorax between 1981 and 2004 were reviewed. The responses of patients to nutritional modifications, octreotide therapy, and surgical interventions were noted. Results: The prevalence of postoperative chylothorax, which developed at a median of 9 days after operation (range, 0 to 24 days), was 0.85% (51 of 5,995). Four patients died, and among the 47 survivors the median duration and total volume of chylous drainage was 15 days (range, 1 to 89 days) and 156 mL/kg (range, 3 to 6,476), respectively. The duration of chyle output was significantly longer after the Fontan-type procedures (p = 0.0006). Twenty-one patients were diagnosed between 1981 and 1999 and managed by nutritional modifications, 2 of whom required further surgical interventions. Of the 30 patients diagnosed between 2000 and 2004, 12 responded to nutritional modifications alone while 18 were started on octreotide therapy at a median of 19.5 days (range, 7 to 35 days) after the onset of chylothorax. Fifteen of the 18 (83%) patients responded to octreotide therapy at 15.3 ± 5.5 days after starting octreotide, while 3 required further surgical interventions. None developed side effects from octreotide therapy. Conclusions: Octreotide has been incorporated into the management algorithm of postoperative chylothorax and appears to be a useful adjunctive therapy. © 2006 The Society of Thoracic Surgeons.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationAnnals Of Thoracic Surgery, 2006, v. 82 n. 5, p. 1650-1656 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.athoracsur.2006.05.116
 
dc.identifier.doihttp://dx.doi.org/10.1016/j.athoracsur.2006.05.116
 
dc.identifier.epage1656
 
dc.identifier.issn0003-4975
2012 Impact Factor: 3.454
2012 SCImago Journal Rankings: 1.404
 
dc.identifier.issue5
 
dc.identifier.pmid17062221
 
dc.identifier.scopuseid_2-s2.0-33750063968
 
dc.identifier.spage1650
 
dc.identifier.urihttp://hdl.handle.net/10722/170379
 
dc.identifier.volume82
 
dc.languageeng
 
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsur
 
dc.publisher.placeUnited States
 
dc.relation.ispartofAnnals of Thoracic Surgery
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshAdolescent
 
dc.subject.meshAdult
 
dc.subject.meshCardiac Surgical Procedures - Adverse Effects
 
dc.subject.meshChild
 
dc.subject.meshChild, Preschool
 
dc.subject.meshChylothorax - Etiology - Therapy
 
dc.subject.meshDiet Therapy
 
dc.subject.meshFemale
 
dc.subject.meshGastrointestinal Agents - Therapeutic Use
 
dc.subject.meshHeart Defects, Congenital - Surgery
 
dc.subject.meshHumans
 
dc.subject.meshInfant
 
dc.subject.meshInfant, Newborn
 
dc.subject.meshMale
 
dc.subject.meshOctreotide - Therapeutic Use
 
dc.subject.meshTriglycerides - Therapeutic Use
 
dc.titleChylothorax in Children After Congenital Heart Surgery
 
dc.typeArticle
 
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<contributor.author>Lau, W</contributor.author>
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<contributor.author>Cheung, Yf</contributor.author>
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<description.abstract>Background: A definitive management strategy for postoperative chylothorax remains elusive. We reviewed our experience in the management of chylothorax in children after congenital heart surgery. Methods: The case records of 51 patients, with a median age of 11 months (range, 4 days to 19.6 years), diagnosed to have postoperative chylothorax between 1981 and 2004 were reviewed. The responses of patients to nutritional modifications, octreotide therapy, and surgical interventions were noted. Results: The prevalence of postoperative chylothorax, which developed at a median of 9 days after operation (range, 0 to 24 days), was 0.85% (51 of 5,995). Four patients died, and among the 47 survivors the median duration and total volume of chylous drainage was 15 days (range, 1 to 89 days) and 156 mL/kg (range, 3 to 6,476), respectively. The duration of chyle output was significantly longer after the Fontan-type procedures (p = 0.0006). Twenty-one patients were diagnosed between 1981 and 1999 and managed by nutritional modifications, 2 of whom required further surgical interventions. Of the 30 patients diagnosed between 2000 and 2004, 12 responded to nutritional modifications alone while 18 were started on octreotide therapy at a median of 19.5 days (range, 7 to 35 days) after the onset of chylothorax. Fifteen of the 18 (83%) patients responded to octreotide therapy at 15.3 &#177; 5.5 days after starting octreotide, while 3 required further surgical interventions. None developed side effects from octreotide therapy. Conclusions: Octreotide has been incorporated into the management algorithm of postoperative chylothorax and appears to be a useful adjunctive therapy. &#169; 2006 The Society of Thoracic Surgeons.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong