Article: Chylothorax in Children After Congenital Heart Surgery
| Title | Chylothorax in Children After Congenital Heart Surgery |
|---|---|
| Authors | Chan, Sy1 Lau, W1 Wong, WHS1 Cheng, Lc1 Chau, AKT1 Cheung, Yf1 |
| Issue Date | 2006 |
| Publisher | Elsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsur |
| Citation | Annals 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 |
| 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 ± 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. |
| ISSN | 0003-4975 2011 Impact Factor: 3.741 2011 SCImago Journal Rankings: 0.229 |
| DOI | http://dx.doi.org/10.1016/j.athoracsur.2006.05.116 |
| References | References in Scopus |
| dc.contributor.author | Chan, Sy |
|---|---|
| dc.contributor.author | Lau, W |
| dc.contributor.author | Wong, WHS |
| dc.contributor.author | Cheng, Lc |
| dc.contributor.author | Chau, AKT |
| dc.contributor.author | Cheung, Yf |
| dc.date.accessioned | 2012-10-30T06:07:54Z |
| dc.date.available | 2012-10-30T06:07:54Z |
| dc.date.issued | 2006 |
| dc.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 ± 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.nature | Link_to_subscribed_fulltext |
| dc.identifier.citation | Annals 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.doi | http://dx.doi.org/10.1016/j.athoracsur.2006.05.116 |
| dc.identifier.epage | 1656 |
| dc.identifier.issn | 0003-4975 2011 Impact Factor: 3.741 2011 SCImago Journal Rankings: 0.229 |
| dc.identifier.issue | 5 |
| dc.identifier.pmid | 17062221 |
| dc.identifier.scopus | eid_2-s2.0-33750063968 |
| dc.identifier.spage | 1650 |
| dc.identifier.uri | http://hdl.handle.net/10722/170379 |
| dc.identifier.volume | 82 |
| dc.language | eng |
| dc.publisher | Elsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/athoracsur |
| dc.publisher.place | United States |
| dc.relation.ispartof | Annals of Thoracic Surgery |
| dc.relation.references | References in Scopus |
| dc.subject.mesh | Adolescent |
| dc.subject.mesh | Adult |
| dc.subject.mesh | Cardiac Surgical Procedures - Adverse Effects |
| dc.subject.mesh | Child |
| dc.subject.mesh | Child, Preschool |
| dc.subject.mesh | Chylothorax - Etiology - Therapy |
| dc.subject.mesh | Diet Therapy |
| dc.subject.mesh | Female |
| dc.subject.mesh | Gastrointestinal Agents - Therapeutic Use |
| dc.subject.mesh | Heart Defects, Congenital - Surgery |
| dc.subject.mesh | Humans |
| dc.subject.mesh | Infant |
| dc.subject.mesh | Infant, Newborn |
| dc.subject.mesh | Male |
| dc.subject.mesh | Octreotide - Therapeutic Use |
| dc.subject.mesh | Triglycerides - Therapeutic Use |
| dc.title | Chylothorax in Children After Congenital Heart Surgery |
| dc.type | Article |
Author Affiliations
- The University of Hong Kong

