title: [Chylothorax in practice of thoracic and cardiovascular surgeon].
abstract: OBJECTIVE
  to improve the results and current pathogenetic treatment of chylorrhea.
  
  
  METHODS
  Thirty seven patients with chylothorax have been treated for the period 2004-2014. In 34 cases traumatic chylothorax developed after surgery and in 3 cases - after intensive care for therapeutic diseases and great veins catheterization. Chylothorax was predominantly diagnosed by X-ray method. Herewith, hydrothorax was established and its nature was defined using laboratory survey. Presence of neutral fat in pleural drainage is the sign of chylothorax. Pathogenetic treatment was often delayed (up to 4.5 months) due to poor awareness of physicians about this pathological process. 6 patients underwent thoracic duct ligation above diaphragm due to ineffective therapy.
  
  
  RESULTS
  Medical therapy had good clinical effect in 83.8% of cases. Postoperatively 1 patient died for single lung inflammation on background of postoperative chylothorax after right-sided pneumonectomy. In other cases chylothora was eliminated with no recurrence in remote postoperative period. It is difficult to recognize injury of thoracic duct or its great branches during surgery. In these cases prolonged thoracic duct ligation above diaphragm is indicated.
authors.affiliation: Sechenov First Moscow State Medical University of Ministry of Health, Moscow, Russia.
authors.forename: V D
authors.initials: VD
authors.lastname: Parshin
mesh_terms: D000328:Adult; D000368:Aged; D002916:Chylothorax / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D000072700:Conservative Treatment / Q000379:methods*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008026:Ligation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011859:Radiography / Q000379:methods; D013514:Surgical Procedures, Operative / Q000009:adverse effects* / Q000379:methods; D013897:Thoracic Duct / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery