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
2011 Impact Factor: 3.741
2011 SCImago Journal Rankings: 0.229
DOIhttp://dx.doi.org/10.1016/j.athoracsur.2006.05.116
ReferencesReferences in Scopus
DC Field
Value
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
2011 Impact Factor: 3.741
2011 SCImago Journal Rankings: 0.229
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
Author Affiliations
  1. The University of Hong Kong