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Treatment options in patients with chylothorax
Hans H Schild1, Christian P Strassburg, Armin Welz
1Department of Radiology, University Hospital of Bonn, Department of Internal Medicine I at the University Hospital of Bonn, Clinic and Policlinic of Cardiac Surgery, University Hospital of Bonn, Clinic and Policlinic of General, Visceral, Thoracic, and Cardiovascular Surgery, University Hospital of Bonn.
Deutsches Arzteblatt International
|December 17, 2013
Summary
Chylothorax management includes conservative, surgical, and interventional radiology options. Percutaneous thoracic duct embolization offers a minimally invasive approach with high success and low complication rates.
Area of Science:
- Thoracic Medicine
- Interventional Radiology
- Lymphatic Physiology
Background:
- Chylothorax involves lymphatic fluid accumulation in the pleural space due to vessel leakage.
- Commonly associated with thoracic surgery and tumors, with no prior prospective trials.
- Current treatment options lack comparative prospective data.
Purpose of the Study:
- To review and compare treatment options for chylothorax.
- To assess the efficacy and safety of various chylothorax interventions.
Main Methods:
- Selective PubMed database search (1995-2013).
- Emphasis on comparative assessment of treatment modalities.
- Review of conservative, surgical, and interventional radiological approaches.
Main Results:
- Conservative treatment success: 20%-80%.
- Surgical success rates vary (25%-95%) with significant morbidity (up to 38%) and mortality (up to 25%).
- Interventional radiology (e.g., embolization) shows ~70% success, up to 80% healing, with ~3% complication rate, even post-surgery.
Conclusions:
- Interventional radiology is a viable option for chylothorax management.
- It complements conservative and surgical treatments.
- Availability of interventional radiology is currently limited.
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