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首页> 外文期刊>Journal of cardiac surgery. >Postoperative chylothorax: differences between patients who received median sternotomy or lateral thoracotomy for congenital heart disease.
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Postoperative chylothorax: differences between patients who received median sternotomy or lateral thoracotomy for congenital heart disease.

机译：术后乳糜胸：因先天性心脏病而接受正中胸骨切开术或外侧胸廓切开术的患者之间的差异。

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BACKGROUND: Chylothorax after surgery for congenital heart disease is rare. We wanted to compare the different presentations of chylothorax in patients who received median sternotomy or lateral thoracotomy. PATIENTS AND METHODS: We retrospectively studied pediatric patients with congenital heart disease who received palliative or corrective surgeries and developed postoperative chylothorax between January 1992 and July 2003. Patients were divided into two groups by the type of surgery: median sternotomy and lateral thoracotomy. The average daily fluid amount (mL/kg/24 hours), latency period, duration of chylothorax, and requirement for surgery were compared. RESULTS: Seventeen patients (11 boys, 6 girls; mean age, 14.0 +/- 12.8-month-old) were enrolled. Diagnoses were tetralogy of Fallot (n = 8), right isomerism with complex heart defects (n = 3), patent ductus arteriosus (n = 2), transposition of the great artery (n = 1), ventricular septal defect (n = 1), and endocardial cushion defect (n = 2). There were 9 in the lateral thoracotomy group and 8 in the median sternotomy group. Only one patient required surgery because of the failure of conservative treatment. The lateral thoracotomy group had a significantly lower average body weight (6.9 +/- 2.9 kg vs. 11.0 +/- 3.8 kg) and longer average latency period before postoperative chylothorax (15.1 +/- 9.2 days vs. 7.2 +/- 4.7 days). CONCLUSION: The majority of pediatric patients who develop chylothorax after cardiac surgery can be successfully managed by medical treatment only. To avoid complications in pediatric patients after cardiac surgery, chylothorax should be suspected for patients with unexplainable, prolonged, and abundant pleural effusion.
机译：背景：先天性心脏病手术后的胸廓胸部很少见。我们想比较接受中位胸骨切开术或外侧胸廓切开术患者乳糜胸的不同表现。病人和方法：我们回顾性研究了1992年1月至2003年7月间接受姑息或矫正手术并发展为术后胸腔炎的先天性心脏病小儿患者。按手术类型将患者分为两组：中位胸骨切开术和侧位胸廓切开术。比较平均每日体液量（mL / kg / 24小时），潜伏期，乳糜胸持续时间和手术需求。结果：共纳入17例患者（男11例，女6例;平均年龄14.0 +/- 12.8个月大）。诊断为法洛四联症（n = 8），右侧异构体伴有复杂的心脏缺陷（n = 3），动脉导管未闭（n = 2），大动脉移位（n = 1），室间隔缺损（n = 1） ）和心内膜垫缺损（n = 2）。外侧开胸手术组有9例，正中胸骨切开术组有8例。由于保守治疗失败，只有一名患者需要手术。外侧胸廓切开术组的平均体重显着降低（6.9 +/- 2.9 kg vs. 11.0 +/- 3.8 kg），术后乳糜胸的平均潜伏期更长（15.1 +/- 9.2天vs. 7.2 +/- 4.7天）。结论：大多数心脏手术后发生乳糜胸的小儿患者只能通过药物治疗才能成功治疗。为避免小儿心脏手术后出现并发症，对于无法解释的，长期的和大量胸腔积液的患者，应怀疑乳糜胸。

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