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South African Journal of Surgery

On-line version ISSN 2078-5151
Print version ISSN 0038-2361

S. Afr. j. surg. vol.48 n.3 Cape Town Aug. 2010




Successful conservative treatment of chylothorax following oesophagectomy - a clinical algorithm



Frank Benedix; Hans-Ulrich Schulz; Hubert Scheidbach; Hans Lippert; Frank Meyer

M.D. Department of Surgery, University Hospital, Magdeburg, Germany




OBJECTIVES: Chylothorax is an infrequent but serious complication after thoracic surgery. Optimal management is still controversial. Surgical re-interventions are associated with significant morbidity and mortality.
DESIGN: During a 2-year period, 3 patients developed chylothorax after oesophagectomy. This was treated conservatively, following our departmental protocol.
RESULTS: Conservative management (total parenteral nutrition, bowel rest, pleural drainage and octreotide, followed by a low-fat diet) was successful in all 3 cases within a reasonable period of time (14 - 18 days).
CONCLUSION: We recommend conservative measures as the first-line treatment for postoperative chylothorax.


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