TY - JOUR T1 - Surgical treatment of postoperative chylothorax with thoracoscopy JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p2428 AU - Shuhrat Khudaybergenov AU - Georgy Pahomov AU - Orticali Irisov AU - Rustem Hayaliev Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p2428.abstract N2 - We studied the results of the examination and treatment of 14 patients with postoperative chylothorax for the period from 1999 to 2010. There were 11 men (78,6%) and 3 women (21,4%), the mean age was 45.5±4.34 years. Pleural effusion in all patients was one-sided, i.e. on the side of the operation.The cause of chylothorax of all the patients was surgery in the thoracic cavity -thoracotomy with resection of the lung and mediastinal lymph dissection (8 cases), lung resection without lymph dissection (2 cases), mediastinal tumor resection (3 cases), and pneumonectomy with intrapericardial treatment of vascular root of the lung (1 patient). Pleural effusion during chylothorax is rated as the milky in 6 (42.9%) cases, festering in 1 (7.1%), serous in 4 (28.6%) and hemorrhagic in 3 (21,4%) cases. The average concentration of triglycerides in the exudates was 7.13±2.12 mmol/liter. The thoracoscopy was performed to all the patients with drainage of the pleural cavity, a diet with a decrease in the amount of fat was prescribed. Total parenteral nutrition was originally required for 4 patients, and 3 patients were urged to follow it due to the ongoing chylorrhea after 3-4 days. Sandostatin was included in the conservative treatment measures of 5 patients.Conservative measures were effective in 9 patients. One patient underwent pleurodesis with intrapleural injection of Iodine polyvinylpyrrolidone complex solution. Other patients after unsuccessful conservative treatment for 7-10 days underwent thoracic lymphatic duct ligation. In the absence of the conservative measures effect for 7-10 days and in significant losses of lymph the surgical treatment was advised. Method of choice is ligation of the thoracic lymphatic duct. ER -