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- Title
Video-assisted thoracoscopy as an option in the surgical treatment of chylothorax after cardiac surgery in children.
- Authors
Pego-Fernandes, Paulo Manuel; Nascimbem, Mauro Boldrini; Ranzani, Otávio T.; Shimoda, Mônica Satsuki; Monteiro, Rosângela; Jatene, Fábio Biscegli
- Abstract
Objective: To evaluate the use of video-assisted thoracoscopy in the surgical treatment of chylothorax developed after the surgical correction of congenital heart disease in children. Methods: We reviewed the medical charts of 3,092 children who underwent surgery for congenital heart disease between February of 2002 and February of 2007 at the Heart Institute of the University of São Paulo School of Medicine Hospital das Clínicas, in São Paulo, Brazil. Results: Of the 3,092 children, 64 (2.2%) presented with chylothorax as a postoperative complication. In 50 (78.1%) of those patients, the clinical management was successful, whereas it failed in 14 (21.9%), all of whom were then submitted to thoracic duct ligation by video-assisted thoracoscopy. The thoracic duct ligation was successful in 12 patients (86%) but failed in 2. In the postoperative period, additional clinical measures, such as a low-fat diet and parenteral nutrition, were required in order to resolve those 2 cases. There was no surgical morbidity or mortality. Of the 14 patients who underwent thoracic duct ligation, 5 (35%) died due to cardiac or infectious complications. Conclusions: Video-assisted thoracic duct ligation can be safely performed in patients with severe heart disease, and the outcomes are favorable.
- Subjects
THORACOSCOPY; SURGICAL therapeutics; CHYLOTHORAX; CARDIAC surgery; THORACIC duct; CONGENITAL heart disease; JUVENILE diseases
- Publication
Brazilian Journal of Pulmonology / Jornal Brasileiro de Pneumologia, 2011, Vol 37, Issue 1, p28
- ISSN
1806-3713
- Publication type
Article