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Incidence and Treatment of Chylothorax in Children Undergoing Corrective Surgery for Congenital Heart Diseases

INTRODUCTION: Chylothorax is a lymphatic extravasation into pleural cavity and its incidence is 0.25%-5.3% in children undergoing cardiac surgery. OBJECTIVE: To evaluate the incidence of chylothorax in pediatrics patients operated, linking it in each surgical intervention. Evaluate treatment types a...

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Autores principales: Christofe, Nicolle Martin, Pessotti, Cristiane Felix Ximenes, Paiva, Laércio, Jatene, Ieda Biscegli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Cirurgia Cardiovascular 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701103/
https://www.ncbi.nlm.nih.gov/pubmed/29211219
http://dx.doi.org/10.21470/1678-9741-2017-0011
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author Christofe, Nicolle Martin
Pessotti, Cristiane Felix Ximenes
Paiva, Laércio
Jatene, Ieda Biscegli
author_facet Christofe, Nicolle Martin
Pessotti, Cristiane Felix Ximenes
Paiva, Laércio
Jatene, Ieda Biscegli
author_sort Christofe, Nicolle Martin
collection PubMed
description INTRODUCTION: Chylothorax is a lymphatic extravasation into pleural cavity and its incidence is 0.25%-5.3% in children undergoing cardiac surgery. OBJECTIVE: To evaluate the incidence of chylothorax in pediatrics patients operated, linking it in each surgical intervention. Evaluate treatment types and efficiency. METHODS: Retrospective study using medical records of children undergoing cardiac surgery in the Hospital do Coração between 2004 and 2014. For statistical analysis, qualitative variables by absolute frequency and relative frequency; quantitative variables, by median of 25 and 75 percentiles, as they did not present normal distribution (Shapiro-Wilk, P<0.05). The Chi-square test was used for the association between type of treatment and result. The adopted confidence level was 95%. RESULTS: Incidence of chylothorax was 2.1% (0.9% in intracardiac surgery, 1.7% correction of patent ductus arteriosus and aortic coarctation, 8.3% Glenn's surgery, 11.8% total cavopulmonary surgery and 3% in others). Among treatments, fasting associated with total parenteral nutrition (TPN) resolved 51% of the cases. Hypoglossal diet had failed treatment and surgical referral in 22% of the cases. Fasting with TPN associated with octreotide had success in the treatment of chylothorax in a period exceeding 15 days in 78% of cases, and 3.7% were referred for surgery. CONCLUSION: According to the results, incidence of chylothorax was 2.18%. Treatment with fasting and TPN leads to resolutions in 86.5%, and the association with octreotide was successful in 85.1% of cases, showing an efficient option, while the treatment with hypoglossal diet had therapeutic failure in 22% of the cases in which it was used.
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spelling pubmed-57011032017-11-28 Incidence and Treatment of Chylothorax in Children Undergoing Corrective Surgery for Congenital Heart Diseases Christofe, Nicolle Martin Pessotti, Cristiane Felix Ximenes Paiva, Laércio Jatene, Ieda Biscegli Braz J Cardiovasc Surg Original Article INTRODUCTION: Chylothorax is a lymphatic extravasation into pleural cavity and its incidence is 0.25%-5.3% in children undergoing cardiac surgery. OBJECTIVE: To evaluate the incidence of chylothorax in pediatrics patients operated, linking it in each surgical intervention. Evaluate treatment types and efficiency. METHODS: Retrospective study using medical records of children undergoing cardiac surgery in the Hospital do Coração between 2004 and 2014. For statistical analysis, qualitative variables by absolute frequency and relative frequency; quantitative variables, by median of 25 and 75 percentiles, as they did not present normal distribution (Shapiro-Wilk, P<0.05). The Chi-square test was used for the association between type of treatment and result. The adopted confidence level was 95%. RESULTS: Incidence of chylothorax was 2.1% (0.9% in intracardiac surgery, 1.7% correction of patent ductus arteriosus and aortic coarctation, 8.3% Glenn's surgery, 11.8% total cavopulmonary surgery and 3% in others). Among treatments, fasting associated with total parenteral nutrition (TPN) resolved 51% of the cases. Hypoglossal diet had failed treatment and surgical referral in 22% of the cases. Fasting with TPN associated with octreotide had success in the treatment of chylothorax in a period exceeding 15 days in 78% of cases, and 3.7% were referred for surgery. CONCLUSION: According to the results, incidence of chylothorax was 2.18%. Treatment with fasting and TPN leads to resolutions in 86.5%, and the association with octreotide was successful in 85.1% of cases, showing an efficient option, while the treatment with hypoglossal diet had therapeutic failure in 22% of the cases in which it was used. Sociedade Brasileira de Cirurgia Cardiovascular 2017 /pmc/articles/PMC5701103/ /pubmed/29211219 http://dx.doi.org/10.21470/1678-9741-2017-0011 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Christofe, Nicolle Martin
Pessotti, Cristiane Felix Ximenes
Paiva, Laércio
Jatene, Ieda Biscegli
Incidence and Treatment of Chylothorax in Children Undergoing Corrective Surgery for Congenital Heart Diseases
title Incidence and Treatment of Chylothorax in Children Undergoing Corrective Surgery for Congenital Heart Diseases
title_full Incidence and Treatment of Chylothorax in Children Undergoing Corrective Surgery for Congenital Heart Diseases
title_fullStr Incidence and Treatment of Chylothorax in Children Undergoing Corrective Surgery for Congenital Heart Diseases
title_full_unstemmed Incidence and Treatment of Chylothorax in Children Undergoing Corrective Surgery for Congenital Heart Diseases
title_short Incidence and Treatment of Chylothorax in Children Undergoing Corrective Surgery for Congenital Heart Diseases
title_sort incidence and treatment of chylothorax in children undergoing corrective surgery for congenital heart diseases
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701103/
https://www.ncbi.nlm.nih.gov/pubmed/29211219
http://dx.doi.org/10.21470/1678-9741-2017-0011
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