L'exérèse coelioscopique des phéochromocytomes. Etude détaillée des modifications hémodynamiques peropératoires

in Lyon Chirurgical (1995), 91

Le chylothorax et son traitement

in Lyon Chirurgical (1994), 90(1), 38-44

Chylothorax is an unfrequent pathology defined by fistula between the thoracic duct and one of the pleura. Its spontaneous evolution is worse, with respiratory failure in the acute phase. After a few days ... [more ▼]

Chylothorax is an unfrequent pathology defined by fistula between the thoracic duct and one of the pleura. Its spontaneous evolution is worse, with respiratory failure in the acute phase. After a few days of thoracic tube drainage, hemodynamic, nutritional and immunologic disturbances appear. Since the first thoracic duct ligature by Lampson in 1948, surgical approach has obviously reduced the morbidity and mortality of chylothorax. The new development of the thoracoscopic techniques will allow earlier and less aggressive surgical treatment. However, thoracic surgeons must keep in mind that every intrathoracic operation could induce chylothorax, especially in case of posteriror mediastinal surgery. Chylothorax must be evocated if unusually profuse milky pleural effusion complicate this type of procedure. We discribe the anatomy and the physiology of chylous circulation and we discuss the etiologies and the different therapeutic approaches of chylothorax. [less ▲]