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Thoracoscopic pleural clipping for the management of congenital chylothorax

Margaret E Clark1, Russell K Woo2, Sidney M Johnson2

  • 1Department of Surgery, Tripler Army Medical Center, 1 Jarrett White Rd., Honolulu, HI, 96859, USA. margaret.elise.clark@gmail.com.

Pediatric Surgery International
|August 16, 2015
PubMed

Insights

Parietal pleural clipping is a safe and effective surgical treatment for congenital chylothorax, significantly reducing lymphatic leakage in infants. This minimally invasive technique offers a successful alternative to traditional medical management.

Area of Science:

  • Pediatric Surgery
  • Thoracic Surgery
  • Neonatal Medicine

Background:

  • Congenital chylothorax management involves total parenteral nutrition and tube thoracostomy.
  • These treatments pose risks of fluid shifts and infection due to leukopenia in infants.

Purpose of the Study:

  • To describe the technique of parietal pleural clipping for congenital chylothorax.
  • To evaluate its efficacy as a surgical intervention.

Main Methods:

  • Retrospective review of medical records for infants diagnosed with chylothorax (January 2002 - April 2014).
  • Thoracoscopic parietal pleural clipping performed in six patients due to inability to visualize thoracic duct.

Main Results:

  • Parietal pleural clipping dramatically resolved chylous leakage in all six infants.
  • Average chest tube output decreased from 86.96 ml/kg/day pre-surgery to 6.5 ml/kg/day on post-op day 2.
  • Most surgical patients (5/6) had bilateral disease, successfully treated with clipping.

Conclusions:

  • Thoracoscopic parietal pleural clipping is a straightforward, safe, and successful treatment for congenital chylothorax.
  • This technique offers a viable surgical option for managing this condition.
Abstract

Keywords:
Chyle leakChylothoraxNeonateParietal clippingPleurodesisThoracic duct

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