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The article " Management and overview of postoperative chylothorax after congenital cardiothoracic surgery " is retracted by the Editor-in-Chief, on the request of corresponding author and co-authors who informed errors in data collection after departmental review and post hoc analysis. The article is retracted because the results may be affected due to the errors.
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@#Objective To investigate the impact of thoracic duct ligation (TDL) on metabolism and postoperative complications during esophagectomy in patients with type-2 diabetes mellitus (T2DM). Methods We conducted a retrospective clinical data analysis of 230 esophageal carcinoma patients with T2DM who underwent esophagectomy in our hospital from January 2003 to December 2018. Patients were divided into a TDL+ group (n=112), including 78 males and 34 females aged 63.47±7.23 years, and a TDL– group (n=118), including 84 males and 34 females aged 64.38±7.57 years. We compared the blood glucose, liver function parameters and lipid metabolic parameters at different time points before and after surgery. In addition, we compared the postoperative major complications between the two groups. Propensity score-matched (PSM) was used to control the observed confounders. Results Compared with the TDL–group, patients in TDL+ group had higher blood glucose level (P<0.05, except the fourth postoperative day). The total protein and albumin levels on the first and fourth postoperative days in the TDL+ group were lower than those in the TDL– group (P<0.05). The alanine transaminase (P=0.027) and aspartate transaminase (P=0.007) levels on the fourth postoperative day in the TDL+ group were higher than those in the TDL– group. More pulmonary complications (P=0.014) and anastomotic leaks (P=0.047) were found in the TDL+ group. Conclusion Given that TDL may aggravate metabolic disorders, increase anastomotic leaks and the pulmonary complications, it is cautious to perform TDL, and prophylactic TDL should not be performed routinely for patients with T2DM.
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Objective To investigate the therapeutic efficacy of somatostatin on chylothorax after congenital heart disease surgery in children.Methods Retrospective analysis was performed in 13 postoperative chylothorax cases from Jan.2003 to Dec.2012,who were divided into control group (n =6) and treatment group (n =7),and there was no significant difference in age,weight,and time of occurrence between the 2 groups.The diagnosis standard for chylothorax was the same.The changes of chylous volume during the treatment were analyzed between 2 groups,and healing time and other data were analyzed too.Results Control group:clinical cure in 3 cases,conservative treatment failed in 3 cases(2 cases recovered after operation and 1 case died).The chyle volume of control group reduced obviously compared with post treatment from beginning [(256.6 ± 124.2) mL/d] to 1 week [(155.5 ± 85.7) mL/d] and 2 weeks [(142.3 ± 110.3) mL/d] later(t =4.623,2.099 ; P =0.002,0.044).But it did not reduce obviously in 3 weeks later[(139.4 ± 113.4) mL/d] (t =1.745,P =0.07).Treatment group:6 cases in treatment group were successful in recovery after conservative treatment and 1 case underwent operation.The chyle volume of treatment group reduced obviously compared with post treatment from beginning to 1 week [(51.2 ± 18.7) mL/d] and 2 weeks [(19.3 ± 7.05) mL/d] later (t =5.549,6.638 ;P =0.001,0.001).Compared with the control group,the difference between 2 groups in post treatment (1 week later,2 weeks hater) was of statistical significance (t =2.900,2.412 ; P =0.014,0.034).The healing time of conservative treatment in 2 groups (only for recovery) had obvious difference [(32.8 ± 1.8) d,(25.2 ± 1.7) d] (t =2.512,P =0.028).Conclusions The use of somatostatin can significantly promote the recovery of chylothorax in children,and it should be actively used in early conservative treatment.
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Postoperative chylothorax following an injury to the thoracic duct during an esophagectomy is a rare, but severe complication, which may lead to serious problems, such as loss of fat and proteins, as well as immunodeficiency. Left untreated, the rate of mortality can rise to over 50%. Herein, 3 patients were treated with a postoperative chylothorax following 280 resections of the esophagus (0.1%). One patient underwent a direct injured thoracic duct ligation by a re-thoracotomy. In the other two patients, relaparotomy and transabdominal double ligation of the thoracic duct were performed. After ligation of the abdominal thoracic duct, the average amount of chyle was markedly reduced. Two patients were discharge from hospital without problems after 36 and 30 days, respectively. Ligation of the thoracic duct, via a relaparotomy, appears to be a simple and safe method for the treatment postoperative chylothorax.