Usefulness of video thoracoscopy in the management of spontaneous and postoperation chylothorax

Peillon, Christophe; D'hont, Ch.; Melki, J.; Fattouh, F.; Perrier, Guillaume; Dujon, Antoine; Testart, J

doi:10.1007/s004649901183

Cited by 31 publications

(14 citation statements)

References 14 publications

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“…It has been demonstrated that thoracic duct ligation may be successfully performed by using video-assisted thoracoscopy in order to avoid a thoracotomy, with apparently lesser postoperative pain, shorter recovery time and hospital stay [9][10][11][12][13][14][15][16][17][18][19][20][21]. However, this technique has not gained wide acceptance at date due to the rarity of this intervention.…”

Section: Discussionmentioning

confidence: 98%

“…Although thoracic duct ligation has been accomplished by thoracoscopy, most surgeons rely on open procedure through a right thoracotomy. Thoracic duct ligation performed by a VATS approach has not gained wide acceptance since most reports deal with anecdotal observations and are based mainly on case reports [5,[9][10][11][12][13][14][15][16][17][18][19][20][21]. We report our experience with thoracoscopic right supra-diaphragmatic thoracic duct ligation in a small series www.elsevier.com/locate/ejcts European Journal of Cardio-thoracic Surgery 29 (2006) 810-814 of six patients presenting with recurrent or persisting nontraumatic chylothorax.…”

Section: Introductionmentioning

confidence: 99%

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

Christodoulou

Ris

Pezzetta

2006

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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

Christodoulou

Ris

Pezzetta

2006

European Journal of Cardio-Thoracic Surgery

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“…7 VATS has became the preferred surgical method to deal with this complication because of its easy manageability and low morbidity. 8 It was performed under local anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Chylothorax after abdominal surgery

Griffo

Luca

Stassano

2010

Gen Thorac Cardiovasc Surg

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Chylothorax is usually a complication of thoracic surgery procedures. Over a 5-year period we encountered three cases of chylothorax following abdominal surgery performed in general surgery units. The initial effusions, not lactescent, were ascribed to a pleural reaction that sometimes is observed during the postoperative period after abdominal surgery. Once the diagnosis was established, the initial conservative treatment failed, and surgery was necessary. In our patients, their debilitated physical condition precluded a thoracotomy approach. A video-assisted thoracoscopy procedure was undertaken, but the extensive pleural effusions, caused in part by the delay in the diagnosis, prevented the exact localization of the duct and its closure. Talc pleurodesis was successfully employed in all patients. Even after abdominal surgery, a persistent pleural effusion should always induce us to suspect a chylothorax.

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“…Although limited in extent, our experience suggests that the present technique (right thoracoscopy in adults) can be performed safely and quickly for aortic surgery-related traumatic chylo-leakage, and that it is perfectly effective. Thus, more prompt surgical management using the present method may be recommendable [6][7][8], particularly in elderly or infant patients who are vulnerable and cannot tolerate prolonged chylous leakage. …”

Section: Commentsmentioning

confidence: 99%

VATS thoracic-duct division for aortic surgery-related chylous leakage

Ohtsuka

Ninomiya

Kobayashi

et al. 2005

European Journal of Cardio-Thoracic Surgery

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Traumatic chylothorax is a serious morbidity due to aortic surgery. We treated this complication successfully by supradiaphragmatic thoracic-duct division in five adults (three men, two women, aged 61.5+/-19.5 years) and a 3-year-old male infant after an average interval of 4.1+/-1.8 days following initial aortic surgery: graft-replacement of subclavian or descending aortic aneurysm in the adults, and correction of aortic coarctation in the infant. A right thoracoscopic approach was used in the adults and the left thoracotomy was re-used in the infant. Individual exposure and division of the thoracic duct was accomplished using an ultrasonic coagulator. The operating time was 22+/-5.5 min for the thoracoscopy cases, and 70 min for the infant. There was no mortality and no procedure-related morbidity, and chylous leakage ceased immediately in all patients. There was no recurrence of chylothorax during a mean follow-up period of 17+/-9.7 months. Despite our limited experience, we conclude that the present supradiaphragmatic thoracic duct division technique (right thoracoscopy in adults) is safe and perfectly effective, and therefore prompt application of this method is recommendable for treatment of aortic surgery-related traumatic chylo-leakage, particularly in vulnerable elderly or infant patients.

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Usefulness of video thoracoscopy in the management of spontaneous and postoperation chylothorax

Abstract: We suggest that VATS should be considered the treatment of choice for spontaneous chylothorax and could be indicated earlier in postoperation chylothorax.

Cited by 31 publications

References 14 publications

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

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

Chylothorax after abdominal surgery

VATS thoracic-duct division for aortic surgery-related chylous leakage

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