Chylothorax in congenital diaphragmatic hernia.
OBJECTIVE
Following surgical repair of congenital diaphragmatic hernia (CDH), chylothorax can be present in 7-28% of the cases. It has been associated with prenatal diagnosis, the use of ECMO and prosthetic patches during reparatory surgery. The objective is to present a neonatal unit experience in handling this complication and the search for predictive factors for its appearance in our patients.


METHODS
A retrospective study was carried out between 2003 and 2009.


RESULTS
We found 65 patients with CDH, of which 7 (10.8%) developed a chylothorax, 5 responded to drainage and diet restriction. Octreotide (OCT) was used in two cases that did not respond to the usual treatment. OCT was successful with one patient, while surgical resolution of the chylothorax was necessary in the other. Two patients died, none of them during treatment of chylothorax. We did not find a significant association between chylothorax and the variables studied in these patients.


CONCLUSIONS
Chylothorax is a common complication following CDH repair. We have a low rate of this complication in our institution. Conservative management is an appropriate approach for all patients; OCT could be an alternative to avoid surgery. We did not find any predictive factors for chylothorax in our series.
Zavala
Alejandro
A
Pediatric Surgery Department, School of Medicine, Pontificia Universidad Católica of Chile, Santiago, Chile. azavala@med.puc.cl
Campos
José-Manuel
JM
Riutort
Cecilia
C
Skorin
Ilona
I
Godoy
Loreto
L
Faunes
Miriam
M
Kattan
Javier
J
D002916:Chylothorax / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D004032:Diet; D004322:Drainage; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006548:Hernia, Diaphragmatic / Q000601:surgery*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D015282:Octreotide / Q000627:therapeutic use; D011183:Postoperative Complications / Q000628:therapy*; D012189:Retrospective Studies
D005765:Gastrointestinal Agents; D015282:Octreotide