Savaş DEMİRPENÇE, Seda TUNCA, Barış GÜVEN, Emin Alp ALAYUNT, Vedide TAVLI

Fontan Operasyonu Sonrası Şilotoraks Gelişen Olguda Oktreotidin Etkinliği

Postoperatif şilotoraks, sıklıkla doğumsal kalp hastalıklarının cerrahisi sonrası görülür. Şilotoraks, özellikle tek ventrikül fizyolojisi olan çocuklarda uzamış hastane yatışı, morbidite ve mortalitenin önemli nedenlerinden biridir. Ductus thoracicus ve aksesuvar lenf kanallarının hasarlanması dışında, sistemik venöz basıncın torasik duktus basıncını aştığı Fontan operasyonu şilotoraksa neden olabilir. Diyet modifikasyonlu konservatif tedavi ile oktreotid postoperatif şilotoraksın standart tedavi yöntemi olarak kabul edilmiştir. Biz bu yazıda Fontan girişimi sonrası gelişen ve oktreotid ile başarılı şekilde tedavi edilen bir şilotoraks olgusunu sunduk. Sonuç; özellikle kavapulmoner anastomoz sonrası plevral effüzyon gelişen çocuklarda şilotoraks akla gelmelidir ve cerrahi girişim gereksinimini azaltmak için konservatif tedaviye ek olarak oktreotid eklenmelidir

EFFICACY OF OCTREOTIDE IN CASE WITH CHYLOTHORAX OCCURRING AFTER FONTAN OPERATION

Postoperative chylothorax commonly occurs following surgical repair of congenital heart disease. Chylothorax is one of the main reasons of lengthened hospitalization, morbidity and mortality amongst particularly children with single ventricle physiology. Apart from laceration of ductus thoracicus and accessory lymphatics, Fontan procedure in which systemic venous pressure exceeds thoracic ductus pressure may lead to chylothorax. Conservative therapy with diet modification and octreotide has been accepted as standard therapy of postoperative chylothorax. Here, we report a case of chylothorax arising secondary to Fontan procedure, and treated curatively with octreotide. Conclusion; chylothorax must be considered, especially in children with pleural effusion occurring after cavapulmonary anastamosis, and the octreotide should be added to conservative therapy to reduce the necessity for surgical management of chylothorax

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