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NON-TRAVMATİK ŞİLOTORAKSLI OLGULARIMIZDA DENEYİMLERİMİZ

Year 2005, Volume: 19 Issue: 2, 51 - 55, 01.10.2005

Abstract

Bu çalışmanın amacı non-travmatik şilotorakslı olgularımızda etyoloji ve tedavi yönetimleri konusunda deneyimlerimizi tartışmaktır. Son 6 yılda, non-travmatik şilotorakslı 10 olgu şilotoraks nedeniyle tedavi edildi. Etyoloji, tanı ve tedavi yöntemleri değerlendirildi. Bütün hastalarda ilk olarak kapalı göğüs drenajı ve total parenteral nutrisyon (TPN) ile konservatif tedaviye başlandı. Konservatif tedavi başarısız olduğunda cerrahi müdahale endikasyonu koyuldu. Şilotoraks etyolojisi 5 hastada ilerlemiş malignensi, 4 hastada cerrahiye sekonder iyatrojenik ve bir olguda ise idiopatikti. Konservatif tedavi 8 hastada başarılı olurken, 2 hasta şilotoraks nedeniyle opere edildi. Şilotoraks nadir fakat hayatı tehdit edici bir patolojidir. Öncelikle konservatif tedavi denenmelidir. Bu tedavinin başarısız olduğu, fazla miktarda kaçağı olan, özellikle etyolojisi iyatrojenik olan hastalarda cerrahi endikasyon koyulmalıdır.

References

  • 1. Miller JI. Anatomy of the thoracic duct and chylothorax. In: Shields TW, LoCicero JIII, Ponn RB, eds. General thoracic surgery 5th ed. Philadelphia: Lippincott Williams & Wilkins 2000; 747-56.
  • 2. Demircan S, Kurul ‹.C. fiilotoraks. Ökten ‹. (ed). Gö¤üs Cerrahisi. Ankara: Sim Matbaac›l›k; 2003: 817-23.
  • 3. Fogli L, Gorini P, Belcastro S. Conservative management of traumatic chylothorax: a case report. Intensive Care Med 1993; 19: 176-7.
  • 4. Chinnock BF. Chylothorax: case report and review of the literature. J Emerg Med 2003; 24: 259-62.
  • 5. Fahimi H, Casselman FP, Mariani M, et al. Current management of postoperative chylothorax. Ann Thorac Surg 2001; 71: 448-51.
  • 6. Barthes FLP, D'Attellis N, Dujon A, et al. Chylothorax complicating pulmonary resection. Ann Thorac Surg 2002; 73: 1714-9.
  • 7. Metin M, Sayar A, Kutlu CA, et al. Travmatik flilotoraks ve tedavi seçenekleri. Solunum Hastal›klar› 1998; 9(2): 333-9.
  • 8. Cerfolio RJ, Allen MS, Deschamps C, et al. Postoperative chylothorax. J Thorac Cardiovasc Surg 1996;112:1361-5.
  • 9. Vallieres E, Shamji FM, Todd TR. Postpneumonectomy chylothorax. Ann Thorac Surg 1993; 55: 1006-8.
  • 10. Shimizu K, Yoshida J, Nishimura M, et al. Treatment strategy for chylothorax after pulmonary resection and lymph node dissection for lung cancer. J Thorac Cardiovasc Surg 2002; 124: 499-502.
  • 11. Sachs PB, Zelch MG, Rice TW, et al. Diagnosis and localization of laceration of the thoracic duct: usefulness of lymphangiogrphy and CT. Am J of Roentgen 1991; 157: 703-5.
  • 12. Akaogi E, Mitsui K, Sohara Y,et.al. Treatment of postoperative chylothorax with intrapleural fibrin glue. Ann Thorac Surg 1989; 48: 116-8.
  • 13. Shirai T, Amano J, Tabake K. Thoracoscopic diagnosis and treatment of chylothorax after pneumonectomy. Ann Thorac Surg 1991; 52: 306-7.

OUR EXPERIENCES IN CASES OF NON-TRAUMATIC CHYLOTHORAX

Year 2005, Volume: 19 Issue: 2, 51 - 55, 01.10.2005

Abstract

The purpose of this study is to analyze our experiences of cyhlothorax and chylothorax management. Last six years, 10 patients were treated for chylothorax succesfully. Underlying aetiologies, surgical techniques and treatment modalities were evaluated. All patients were initially treated by closed thoracic tube drainage and total parenteral nutrition. When the conservative treatment was unsuccessful then surgical intervention was indicated. The aetiology of our chylothoraces was evaluated as tumor in 5 patients, surgical trauma in 4 patients and idiopathic in one patient. Conservative treatment was successful in 8 patients. Two patients underwent operation. Chylothorax is a rare but potentially life-threatening entity in thoracic surgery. Conservative therapy should be attempted first. However, it may be unsuccessful in patients with high flow leaks especially in patients with iatrogenic cylothoraces patients.

References

  • 1. Miller JI. Anatomy of the thoracic duct and chylothorax. In: Shields TW, LoCicero JIII, Ponn RB, eds. General thoracic surgery 5th ed. Philadelphia: Lippincott Williams & Wilkins 2000; 747-56.
  • 2. Demircan S, Kurul ‹.C. fiilotoraks. Ökten ‹. (ed). Gö¤üs Cerrahisi. Ankara: Sim Matbaac›l›k; 2003: 817-23.
  • 3. Fogli L, Gorini P, Belcastro S. Conservative management of traumatic chylothorax: a case report. Intensive Care Med 1993; 19: 176-7.
  • 4. Chinnock BF. Chylothorax: case report and review of the literature. J Emerg Med 2003; 24: 259-62.
  • 5. Fahimi H, Casselman FP, Mariani M, et al. Current management of postoperative chylothorax. Ann Thorac Surg 2001; 71: 448-51.
  • 6. Barthes FLP, D'Attellis N, Dujon A, et al. Chylothorax complicating pulmonary resection. Ann Thorac Surg 2002; 73: 1714-9.
  • 7. Metin M, Sayar A, Kutlu CA, et al. Travmatik flilotoraks ve tedavi seçenekleri. Solunum Hastal›klar› 1998; 9(2): 333-9.
  • 8. Cerfolio RJ, Allen MS, Deschamps C, et al. Postoperative chylothorax. J Thorac Cardiovasc Surg 1996;112:1361-5.
  • 9. Vallieres E, Shamji FM, Todd TR. Postpneumonectomy chylothorax. Ann Thorac Surg 1993; 55: 1006-8.
  • 10. Shimizu K, Yoshida J, Nishimura M, et al. Treatment strategy for chylothorax after pulmonary resection and lymph node dissection for lung cancer. J Thorac Cardiovasc Surg 2002; 124: 499-502.
  • 11. Sachs PB, Zelch MG, Rice TW, et al. Diagnosis and localization of laceration of the thoracic duct: usefulness of lymphangiogrphy and CT. Am J of Roentgen 1991; 157: 703-5.
  • 12. Akaogi E, Mitsui K, Sohara Y,et.al. Treatment of postoperative chylothorax with intrapleural fibrin glue. Ann Thorac Surg 1989; 48: 116-8.
  • 13. Shirai T, Amano J, Tabake K. Thoracoscopic diagnosis and treatment of chylothorax after pneumonectomy. Ann Thorac Surg 1991; 52: 306-7.
There are 13 citations in total.

Details

Other ID JA45HK55JJ
Journal Section Research Article
Authors

Şeyda Örs Kaya This is me

Gökhan Yuncu This is me

Serpil Sevinç This is me

Kenan Can Ceylan This is me

Ahmet Üçvet This is me

Şamil Günay This is me

Atilla Özenoğlu This is me

Publication Date October 1, 2005
Published in Issue Year 2005 Volume: 19 Issue: 2

Cite

APA Kaya, Ş. Ö., Yuncu, G., Sevinç, S., Ceylan, K. C., et al. (2005). NON-TRAVMATİK ŞİLOTORAKSLI OLGULARIMIZDA DENEYİMLERİMİZ. İzmir Göğüs Hastanesi Dergisi, 19(2), 51-55.