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BIBTEX RIS

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

2017; Brazilian Society of Cardiovascular Surgery; Linguagem: Inglês

10.21470/1678-9741-2017-0011

ISSN

1678-9741

Autores

Nicolle Martin Christofe, Cristiane Félix Ximenes Pessotti, Laércio da Silva Paiva, Ieda Biscegli Jatene,

Tópico(s)

Vascular Malformations and Hemangiomas

Resumo

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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