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[Modern Treatment Options for Postoperative Chylothorax: a Systematic Review]
1Klinik für Thoraxchirurgie, Regiomed Kliniken GmbH, Sonneberg/Coburg.
Pneumologie (Stuttgart, Germany)
|June 11, 2021
Summary
Chylothorax treatment begins conservatively, escalating to surgical or interventional radiological procedures if needed. Success rates vary by method and cause, with modern options offering high efficacy but availability may be limited.
Area of Science:
- Thoracic Surgery
- Interventional Radiology
- Pulmonology
Background:
- Chylothorax is a complex condition often resulting from surgery, trauma, or malignancy.
- Evidence-based treatment guidelines are limited due to a lack of prospective trials, relying heavily on clinical experience and retrospective data.
Purpose of the Study:
- To provide a comprehensive review of current chylothorax treatment options.
- To analyze the advantages and disadvantages of various therapeutic approaches.
Main Methods:
- A literature search was conducted on PubMed, focusing on publications within the last ten years.
- Keywords used included "chylothorax," with a priority on studies comparing treatment modalities.
- Clinical experience was used to critically evaluate treatment options.
Main Results:
- Conservative treatment success rates vary widely (3-90%) based on etiology.
- Non-invasive and semi-invasive procedures show success rates of 50-100%.
- Surgical options like thoracic duct ligation, pleurodesis, or shunts achieve 64-100% success, with morbidity/mortality up to 25%.
Conclusions:
- Initial treatment for chylothorax should be conservative, with escalation to more aggressive therapies as indicated.
- Interventional radiology offers safe and effective treatment options, complementing conservative and surgical approaches.
- Availability of interventional radiological procedures may be limited to specialized centers.
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