Background: Chylothorax is a rare complication after adult cardiovascular
surgery. Chylothorax directly affects postoperative course and morbidity.
Methods: Data for this prospective study was collected between July 2017 and
August 2021. Twenty patients who had adult cardiac surgery were included in
our study. Demographic characteristics, operative and postoperative data
were collected and analyzed. Somatostatin injections were used to control
chyle leakage. Failure of conservative treatment was the indication of surgery.
Results: This study included 20 patients, 13 males and 7 females, who recently
underwent adult cardiovascular surgery. The mean age was 47.7±13.27 years.
The mean duration for chyle effusion was 4.35±1.98 days, while the mean
duration of drainage was 12.15±2.56 days. Analysis of pleural fluid revealed
mean pH value = 7.3±0.05, mean total protein =2.7±0.3 g/dL, mean pleural
glucose concentrations =123±33 mg/dl, mean cholesterol level =43±17 mg/dL,
mean triglyceride level =489±39 mg/dL, and mean chylomicron level =7±0.4
mg/dl. There was a statistical significance regarding the response of
postoperative chylothorax to somatostatin therapy (p=0.001). Surgery (mass
ligation) was indicated in 4 cases secondary to failure of conservative
treatment. There was a significant difference between ICT drainage/day in
patients who were managed conservatively and those who were managed
surgically (p =0.0001). Conclusion: Chylothorax is more common following
CABG and Aortic arch surgeries, and it has a significant impact on the
postoperative course and morbidity. The diagnosis and therapy should be
initiated as soon as possible. Conservative management is feasible in 80% of
cases |
