Eur J Pediatr Surg 2010; 20(6): 391-394
DOI: 10.1055/s-0030-1261956
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Postoperative Chylothorax in Congenital Diaphragmatic Hernia

M. Kamiyama1 , N. Usui1 , G. Tani1 , H. Soh1 , S. Kamata1 , K. Nose2 , A. Kubota2 , M. Fukuzawa1
  • 1Osaka University Graduate School of Medicine, Department of Pediatric Surgery, Suita, Japan
  • 2Osaka Medical Center for Maternal and Child Health, Department of Pediatric Surgery, Izumi, Japan
Further Information

Publication History

received February 16, 2010

accepted after revision May 29, 2010

Publication Date:
27 July 2010 (online)

Abstract

Introduction: The mechanisms responsible for postoperative chylothorax in Congenital Diaphragmatic Hernia (CDH) patients remain unclear. The aim of the present study was to examine the clinical features of CDH that may contribute to an association with postoperative chylothorax.

Material and Methods: 198 neonates with CDH, in whom surgical repair of a diaphragmatic defect was performed between 1981 and 2008, were retrospectively studied. The patients were divided into 2 groups; patients with postoperative chylothorax (group I, n=11) and patients without postoperative chylothorax (group II, n=187). The clinical findings were compared between group I and group II to investigate potential predictive parameters for an association with chylothorax. Moreover, the clinical findings and treatments were evaluated in patients with chylothorax.

Results: 11 of the 198 infants (5.5%) developed a chylothorax. Although the incidence of a prenatal diagnosis was slightly higher in group I, no relationship with other clinical features was found which would indicate the severity of CDH or the occurrence of postoperative chylothorax. Treatment for chylothorax was drainage alone in 2 cases, total parenteral nutrition with drainage in 8 infants and additional intrathoracic OK-432 infusion in 1 patient. No patients required surgical intervention for chylothorax. No recurrences were observed in this patient series.

Conclusions: It was concluded that postoperative chylothorax is not rare in infants after CDH repair. However, no statistically significant predictive parameters for chylothorax were identified, except for the presence of a prenatal diagnosis.

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Correspondence

Dr. Masafumi KamiyamaMD 

Osaka University Graduate School of Medicine

Department of Pediatric Surgery

Yamadaoka 2-2

565-0871 Suita

Japan

Phone: +81-6-6879-3753

Fax: +81-6-6879-3759

Email: kamiyama@pedsurg.med.osaka-u.ac.jp