Onur IŞIK, Muhammet AKYÜZ, Mehmet Fatih AYIK, Yüksel ATAY

Konjenital kalp cerrahisi sonrası şilotoraks tanı ve tedavisine güncel yaklaşım

Şilotoraks, torasik duktusun hasarına bağlı olarak plevral boşlukta şilöz olarak bilinen sütümsü bir sıvı birikimi olup, çocuklarda plevral efüzyonun nispeten nadir bir nedenidir. Çocukluk çağındaki postoperatif şilotoraks ciddi bir komplikasyon olup, yönetimi zorludur. Görülme sıklığı düşük olmasına rağmen enfeksiyon, malnütrisyon, immünsupresyona sebep olabilmesinden dolayı ciddi bir komplikasyon olarak karşımıza çıkabilmektedir. Şilotoraks gelişmesi sonrasında sıvı dengesinin de bozulması postoperatif dönemde hasta yönetimini daha da komplike hale sokabilir. Bu bağlamda pediyatrik kalp cerrahisi sonrası gelişen şilotoraks daha yüksek morbidite ve mortaliteye neden olabilir. Bu yazımızın amacı pediyatrik kalp cerrahisi sonrası gelişen şilotoraks kapsamında kalarak anatomi, etiyoloji, tanı, insidans, patofizyoloji ve güncel yaklaşıma değinmektir.

Current management for diagnosis and treatment of chylothorax after congenital heart surgery

Chylothorax, the accumulation of a milky fluid known as chyle in the pleural space due to damage to the thoracic duct, is a relatively rare cause of pleural effusion in children. Postoperative chylothorax in childhood is a potentially serious complication of any thoracic surgical procedure and its management represents a serious challenge. It has a low prevalence but it can lead to serious complications, such as infection, malnutrition, and immunosuppression, in newborn and infant patients. Once chylothorax occurs, postoperative management is complicated by incremental hydrolability, which requires careful postoperative management. Consequently, chylothorax may cause greater morbidity and mortality in pediatric heart surgery. The intent of our study was to explore the anatomy, etiology, diagnose, incidence, pathophsiology and present the management of this type of chylothorax

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