Application of somatostatin in expectant treatment for postoperative chylothorax in children after congenital heart disease surgery

Abstract

Objective To investigate the therapeutic efficacy of somatostatin on chylothorax after congenital heart disease surgery in children. Methods Retrospective analysis was performed in 13 postoperative chylothorax cases from Jan.2003 to Dec.2012, who were divided into control group (n=6) and treatment group(n=7), and there was no significant difference in age, weight, and time of occurrence between the 2 groups.The diagnosis standard for chylothorax was the same.The changes of chylous volume during the treatment were analyzed between 2 groups, and healing time and other data were analyzed too. Results Control group: clinical cure in 3 cases, conservative treatment failed in 3 cases(2 cases recovered after operation and 1 case died). The chyle volume of control group reduced obviously compared with post treatment from beginning [(256.6±124.2) mL/d]to 1 week[(155.5±85.7) mL/d] and 2 weeks[(142.3±110.3) mL/d] later( t=4.623, 2.099; P=0.002, 0.044). But it did not reduce obviously in 3 weeks later[(139.4±113.4) mL/d](t=1.745, P=0.07). Treatment group: 6 cases in treatment group were successful in recovery after conservative treatment and 1 case underwent operation.The chyle volume of treatment group reduced obviously compared with post treatment from beginning to 1 week [(51.2±18.7) mL/d]and 2 weeks [(19.3±7.05) mL/d]later ( t=5.549, 6.638; P=0.001, 0.001). Compared with the control group, the difference between 2 groups in post treatment(1 week later, 2 weeks later) was of statistical significance(t=2.900, 2.412; P=0.014, 0.034). The healing time of conservative treatment in 2 groups(only for recovery) had obvious difference[(32.8±1.8) d, (25.2±1.7) d](t=2.512, P=0.028). Conclusions The use of somatostatin can significantly promote the recovery of chylothorax in children, and it should be actively used in early conservative treatment. Key words: Somatostatin; Chylothorax; Congenital heart disease; Thoracic duct ligation; Child