Management of postoperative chylothorax

ABSTRACT

To evaluate treatment modalities of iatrogenic post operative chylothorax and describe our current approach this study was conducted at CMH/AFIC Rawalpindi from Aug 2001 to Aug 2003. It included the causative evaluation and management modalities. 11 patients were operated for cardiac and thoracic pathology, which resulted in chylothorax. Chylothorax was diagnosed based on clinical appearance and chemical analysis of pleural fluid. Out of 11 patients, 9 had cardiac procedures while 2 had thoracic operations. All Patients had chest intubation. 9 had drainage within 24 hours, 1 at 48 hours, and 1 after 72 hrs. Initial tube thoracostomy drainage was 1000 to 2500 ml/day. S patients responded to conservative tube thoracostomy and TPN. 2 were operated with in 48 hours with ligation of the leaking site. 4 had to undergo the supra-diaphragmatic enmass ligation via right thoracotomy