M. Kamiyama N. Usui G. Tani Postoperative chylothorax in congenital diaphragmatic hernia Eur J Pediatr Surg 20 6 2010

Abstract

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. One hundred ninety-eight neonates with CDH, in whom surgical repair of CDH was performed, were retrospectively studied. The patients were subdivided 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 both groups to investigate potential predictive parameters. Eleven (5.5%) of the 198 infants developed a chylothorax. Although the incidence of a prenatal diagnosis was slightly higher in group I, no relationship with other clinical features was found that would indicate the severity of CDH or the occurrence of postoperative chylothorax. Treatment of chylothorax was drainage alone in 2 cases, total parenteral nutrition with drainage in 8 cases, and additional intrathoracic OK-432 infusion in 1 patient. No patient required surgical intervention for chylothorax. No recurrences were observed in this series. It was concluded that postoperative chylothorax is not rare after CDH repair. However, no significant predictive parameters could be identified, except for the presence of prenatal diagnosis.