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International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
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Sixteen years of experience with persistent chylothorax in children

Alessio Pini Prato1, Gian L Bava2, Pietro Dalmonte2

  • 1Department of Pediatric Surgery, Giannina Gaslini Institute, Genoa, Italy - alessiopiniprato@ospedale-gaslini.ge.it.

Minerva Pediatrica
|December 19, 2015
PubMed

Insights

Persistent chylothorax in children can be treated surgically. Thoracic duct ligation is an effective option for unresponsive cases, especially right-sided effusions with high output, preventing relapses.

Area of Science:

  • Pediatric Surgery
  • Thoracic Surgery
  • Critical Care Medicine

Background:

  • Persistent chylothorax in children is a rare condition.
  • Conservative management is standard, but surgical intervention is necessary for treatment failures.
  • Idiopathic chylothorax requires effective surgical strategies.

Purpose of the Study:

  • To present surgical treatment outcomes for persistent idiopathic chylothorax.
  • To evaluate the efficacy of thoracic duct ligation in managing this condition.

Main Methods:

  • Retrospective analysis of 9 pediatric patients undergoing surgery for persistent chylothorax (1994-2010).
  • Procedures included pleurodesis and thoracic duct ligation.
  • Data on patient demographics, effusion laterality, and treatment outcomes were collected.

Main Results:

  • Thoracic duct ligation led to complete cessation of chylothorax within a median of 5 days.
  • Pleurodesis cessation took a median of 10 days, with 3 cases failing and requiring subsequent ligation.
  • No relapses occurred in patients who underwent thoracic duct ligation.

Conclusions:

  • Thoracic duct ligation is an effective treatment for persistent, unresponsive chylothorax in children.
  • For right-sided effusions with high output (>20 mL/kg), thoracic duct ligation may be a primary surgical choice.
Abstract

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