SURGICAL ASPECTS OF THE TREATMENT OF CHYLOTHORAX (CLINICAL OBSERVATIONS AND LITERATURE REVIEW)
https://doi.org/10.38181/2223-2427-2022-4-61-69
Abstract
Chylothorax is a rare disease that occurs due to damage to the thoracic lymphatic duct with the outflow of chyle from the lymphatic system into the pleural cavity, usually on the right.
Establishing a final diagnosis for this disease is often associated with additional time costs, due to its relatively low prevalence. Currently, 65 scientific articles in Russian have been written on this topic.
A necessary condition for the successful treatment of this disease is the identification of the root cause of its occurrence with its subsequent elimination.
Despite the available scientific publications on this topic with a description of algorithmic approaches to diagnosis and treatment, sometimes, due to objective circumstances, it is necessary to correct these recommendations to ensure the most adequate treatment for a particular patient.
About the Authors
E. A. GallyamovRussian Federation
Eduard A. Gallyamov – PhD, Professor, Head of the Department
of General Surgery of the First Moscow State Medical University. THEM. Sechenov
A. I. Romanikhin
Russian Federation
Arkady I. Romanikhin – PhD, Thoracic Surgeon
A. V. Nikulin
Russian Federation
Andrey V. Nikulin – Head of the Department of Thoracic Surgery
A. M. Malofei
Russian Federation
Alexander M. Malofei – doctor thoracic surgeon surgeon
G. I. Diduev
Russian Federation
Gamzat I. Diduev – doctor thoracic surgeon
A. I. Surkov
Russian Federation
Anatoly I. Surkov – surgeon
References
1. McGrath EE, Blades Z, Anderson PB. Chylothorax: aetiology, diagnosis and therapeutic options. Respir Med. 2010 Jan;104(1):1-8. https://doi.org/10.1016/j.rmed.2009.08.010
2. Аракелян В.С., Гидаспов Н.А., Куличков П.П., Касьянова Н.Ю., Малинин А.А. Тактика комплексного лечения послеоперационного хилоторакса после протезирования аорты по поводу аортального дивертикула и расслаивающейся аневризмы. Анналы хирургии. 2016. №21 (4). С. 269-274. [Arakelyan V.S., Gidaspov N.A., Kulichkov P.P., Kas'yanova N.YU., Malinin A.A. Taktika kompleksnogo lecheniya posleoperacionnogo hilotoraksa posle protezirovaniya aorty po povodu aortalnogo divertikula i rasslaivayushchejsya anevrizmy. Annaly hirurgii. 2016, №21 (4), pp 269-274. (In Russ.)]
3. Kanna S, Arora S, Goel H, Jindal P, Shad S. Chylothorax after coronary artery bypass grafting: Is it always early? J Card Surg. 2021 Sep;36(9):3402-3404. https://doi.org/10.1111/jocs.15686
4. Goity LD, Itkin M, Nadolski G. An Algorithmic Approach to Minimally Invasive Management of Nontraumatic Chylothorax. Semin Intervent Radiol. 2020 Aug;37(3):269- 273. https://doi.org/10.1055/s-0040-1713444
5. Stange S, Sziklavari Z. Systematische Übersichtsarbeit: moderne Behandlungsverfahren beim postoperativen Chylothorax [Modern Treatment Options for Postoperative Chylothorax: a Systematic Review]. Pneumologie. 2021 Jun;75(6):439-446. German. https://doi.org/10.1055/a-1172-7288
6. Campos Costa F, Mateus JE, Fonseca J. Effect of medium-chain triglycerides in chylothorax composition. Postgrad Med J. 2020 Jan;96(1131):57. https://doi.org/10.1136/postgradmedj-2019-136878
7. Furukawa M, Hara A, Miyazaki R, Yokoyama S, Hayashi M, Tao H, Okabe K. [Assessment of Fat-free Diet for Postoperative Chylothorax]. Kyobu Geka. 2018 Dec;71(13):1063-1065. (In Japanese)
8. Schild HH, Pieper C. Chylothorax: eine Übersicht über aktuelle therapeutische Möglichkeiten [Chylothorax: Current Therapeutic Options]. Zentralbl Chir. 2019 Sep;144( S 01):S24-S30. (In German) https://doi.org/10.1055/a-0831-2649
9. Long WG, Cai B, Liu Y, Wang WJ. Povidone-iodine chemical pleurodesis in treating spontaneous chylothorax in pediatric patients. Ann Palliat Med. 2020 May;9(3):1004- 1012. https://doi.org/10.21037/apm-20-926
10. Козлов Ю.А., Распутин А.А., Ковальков К.А., Полоян С.С., Барадиева П.Ж., Звонков Д.А., Очиров Ч.Б., Черемнов В.С., Капуллер В.М. Химический плевродез с использованием повидон-йода для лечения новорожденных с хилотораксом. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2020. №4, 391-399. [Kozlov YU.A., Rasputin A.A., Kovalkov K.A., Poloyan S.S., Baradieva P.ZH., Zvonkov D.A., Ochirov CH.B., CHeremnov V.S., Kapuller V.M. Himicheskij plevrodez s ispolzovaniem povidon-joda dlya lecheniya novorozhdennyh s hilotoraksom. Rossijskij vestnik detskoj hirurgii, anesteziologii i reanimatologii. 2020. №4, 391-399. (In Russ.)]
11. Reisenauer JS, Puig CA, Reisenauer CJ, Allen MS, Bendel E, Cassivi SD, Nichols FC, Shen RK, Wigle DA, Blackmon SH. Treatment of Postsurgical Chylothorax. Ann Thorac Surg. 2018 Jan;105(1):254-262. https://doi.org/10.1016/j.athoracsur.2017.07.021
12. Takahashi M, Inoue M, Wada T, Kawai G, Machida M, Matsuoka Y. Chylothorax treated with targeted sclerotherapy by direct puncture of the lymphatic leakage site. Radiol Case Rep. 2020 Jun 29;15(8):1398-1402. https://doi.org/10.1016/j.radcr.2020.06.014
13. Машимбаев E.K., Малинин A.A. Этиопатогенез и диагностические аспекты послеоперационного хилоторакса в сердечно-сосудистой хирургии. Анналы хирургии. 2012, №1, С. 10-14. [Mashimbaev E.K., Malinin A.A. Etiopatogenez i diagnosticheskie aspekty posleoperacionnogo hilotoraksa v serdechno-sosudistoj hirurgii. Annaly hirurgii. 2012, №1, S. 10-14. (In Russ.)]
14. Плаксин С.А., Петров М.Е. Ранние реторакотомии при заболеваниях и травмах груди. Вестник хирургии. 2012. №5, С. 20-23. [Plaksin S.A., Petrov M.E. Rannie retorakotomii pri zabolevaniyah i travmah grudi. Vestnik hirurgii. 2012. №5, S. 20-23. (In Russ.)]
15. Шапкин А.А., Ефименко И.В. Хилоторакс в хирургической практике: диагностика и лечение. Клиническая медицина. 2016. №1(1), 69-72. [Shapkin A.A., Efimenko I.V. Hilotoraks v hirurgicheskoj praktike: diagnostika i lechenie. Klinicheskaya medicina. 2016. №1(1), 69-72. (In Russ.)]
16. Белов Ю.В., Миланов Н.О., Степаненко А.Б., Гасанов А.Ф. Хилоторакс в торакальной хирургии. Хирургия. Журнал им. Н.И. Пирогова. 2012;(10):61-64. [Belov IuV, Milanov NO, Stepanenko AB, Gasanov AF. The treatment of chylothorax. Pirogov Russian Journal of Surgery = Khirurgiya. Zurnal im. N.I. Pirogova. 2012;(10):61-64. (In Russ.).]
17. Kahraman D, Keskin G, Khalil E, Dogan OF. Ten-Year Clinical Experience on Chylothorax after Cardiovascular Surgery. Heart Surg Forum. 2020 Feb 27;23(1):E081-E087. https://doi.org/10.1532/hsf.2655
18. Maxey TS. Diaphragm fenestration for chylothorax: Full of holes? J Thorac Cardiovasc Surg. 2017 Dec;154(6):2069. https://doi.org/10.1016/j.jtcvs.2017.08.113
Review
For citations:
Gallyamov E.A., Romanikhin A.I., Nikulin A.V., Malofei A.M., Diduev G.I., Surkov A.I. SURGICAL ASPECTS OF THE TREATMENT OF CHYLOTHORAX (CLINICAL OBSERVATIONS AND LITERATURE REVIEW). Surgical practice (Russia). 2022;(4):61-69. (In Russ.) https://doi.org/10.38181/2223-2427-2022-4-61-69