NON-TRAVMATİK ŞİLOTORAKSLI OLGULARIMIZDA DENEYİMLERİMİZ
Bu çalışmanın amacı non-travmatik şilotorakslı olgularımızda etyoloji ve tedavi yönetimleri konusunda deneyimlerimizi tartışmaktır. Son 6 yılda, non-travmatik şilotorakslı 10 olgu şilotoraks nedeniyle tedavi edildi. Etyoloji, tanı ve tedavi yöntemleri değerlendirildi. Bütün hastalarda ilk olarak kapalı göğüs drenajı ve total parenteral nutrisyon (TPN) ile konservatif tedaviye başlandı. Konservatif tedavi başarısız olduğunda cerrahi müdahale endikasyonu koyuldu. Şilotoraks etyolojisi 5 hastada ilerlemiş malignensi, 4 hastada cerrahiye sekonder iyatrojenik ve bir olguda ise idiopatikti. Konservatif tedavi 8 hastada başarılı olurken, 2 hasta şilotoraks nedeniyle opere edildi. Şilotoraks nadir fakat hayatı tehdit edici bir patolojidir. Öncelikle konservatif tedavi denenmelidir. Bu tedavinin başarısız olduğu, fazla miktarda kaçağı olan, özellikle etyolojisi iyatrojenik olan hastalarda cerrahi endikasyon koyulmalıdır.
OUR EXPERIENCES IN CASES OF NON-TRAUMATIC CHYLOTHORAX
The purpose of this study is to analyze our experiences of cyhlothorax and chylothorax management. Last six years, 10 patients were treated for chylothorax succesfully. Underlying aetiologies, surgical techniques and treatment modalities were evaluated. All patients were initially treated by closed thoracic tube drainage and total parenteral nutrition. When the conservative treatment was unsuccessful then surgical intervention was indicated. The aetiology of our chylothoraces was evaluated as tumor in 5 patients, surgical trauma in 4 patients and idiopathic in one patient. Conservative treatment was successful in 8 patients. Two patients underwent operation. Chylothorax is a rare but potentially life-threatening entity in thoracic surgery. Conservative therapy should be attempted first. However, it may be unsuccessful in patients with high flow leaks especially in patients with iatrogenic cylothoraces patients.
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