Browse > Article
http://dx.doi.org/10.1055/s-0042-1751026

Using Lymphovenous Anastomosis and Lymph Node to Vein Anastomosis for Treatment of Posttraumatic Chylothorax with Increased Thoracic Duct Pressure in 3-Year-Old Child  

Kim, Yeongsong (Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine)
Kim, Hyung B. (Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine)
Pak, Changsik J. (Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine)
Suh, Hyunsuk P. (Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine)
Hong, Joon P. (Department of Plastic Surgery, Asan Medical Center, University of Ulsan, College of Medicine)
Publication Information
Archives of Plastic Surgery / v.49, no.4, 2022 , pp. 549-553 More about this Journal
Abstract
Chylothorax is a rare disease and massive lymph fluid loss can cause life-threatening condition such as severe malnutrition, weight loss, and impaired immune system. If untreated, mortality rate of chylothorax can be up to 50%. This is a case report of a 3-year-old child with iatrogenic chylothorax. Despite conservative treatment and procedures, like perm catheter insertion, the patient failed to improve the respiratory symptoms over 3 months of period. As an alternative to surgical option, such as pleurodesis and thoracic duct ligation which has high complication rate, the patient underwent lymphovenous anastomosis (LVA) and lymph node to vein anastomosis (LNVA). Follow-up at fourth month showed clear lungs without breathing difficulty despite perm catheter removal. This is the first report to show the effectiveness of LVA and LNVA against iatrogenic chylothorax.
Keywords
Iatrogenic chylothorax; supermicrosurgery; lymphovenous anastomosis; lymph node to vein anastomosis;
Citations & Related Records
Times Cited By KSCI : 3  (Citation Analysis)
연도 인용수 순위
1 Weissler JM, Cho EH, Koltz PF, et al. Lymphovenous anastomosis for the treatment of chylothorax in infants: a novel microsurgical approach to a devastating problem. Plast Reconstr Surg 2018;141(06):1502-1507   DOI
2 Hayashida K, Yamakawa S, Shirakami E. Lymphovenous anastomosis for the treatment of persistent congenital chylothorax in a low-birth-weight infant: a case report. Medicine (Baltimore) 2019;98(43):e17575   DOI
3 Kwon JG, Hong DW, Suh HP, Pak CJ, Hong JP. Patient-specific surgical options for breast cancer-related lymphedema: technical tips. Arch Plast Surg 2021;48(03):246-253   DOI
4 Cho MJ, Kwon JG, Pak CJ, Suh HP, Hong JP. The role of duplex ultrasound in microsurgical reconstruction: review and technical considerations. J Reconstr Microsurg 2020;36(07):514-521   DOI
5 McGrath EE, Blades Z, Anderson PB. Chylothorax: aetiology, diagnosis and therapeutic options. Respir Med 2010;104(01):1-8   DOI
6 Aulia I, Yessica EC. Surgical management of male genital lymphedema: a systematic review. Arch Plast Surg 2020;47(01):3-8   DOI
7 Pak CS, Suh HP, Kwon JG, Cho MJ, Hong JP. Lymph node to vein anastomosis (LNVA) for lower extremity lymphedema. J Plast Reconstr Aesthet Surg 2021;74(09):2059-2067   DOI
8 Soto-Martinez M, Massie J. Chylothorax: diagnosis and management in children. Paediatr Respir Rev 2009;10(04):199-207   DOI
9 Koshima I, Inagawa K, Urushibara K, Moriguchi T. Supermicrosurgical lymphaticovenular anastomosis for the treatment of lymphedema in the upper extremities. J Reconstr Microsurg 2000;16(06):437-442   DOI
10 Rosian K, Stanak M. Efficacy and safety assessment of lymphovenous anastomosis in patients with primary and secondary lymphoedema: a systematic review of prospective evidence. Microsurgery 2019;39(08):763-772   DOI
11 Nath DS, Savla J, Khemani RG, Nussbaum DP, Greene CL, Wells WJ. Thoracic duct ligation for persistent chylothorax after pediatric cardiothoracic surgery. Ann Thorac Surg 2009;88(01):246-251   DOI
12 Lee YW, Lee SH, You HJ, Jung JA, Yoon ES, Kim DW. Lymphatic vessel mapping in the upper extremities of a healthy Korean population. Arch Plast Surg 2018;45(02):152-157   DOI
13 Tutor JD. Chylothorax in infants and children. Pediatrics 2014;133(04):722-733   DOI
14 Chan SY, Lau W, Wong WH, Cheng LC, Chau AK, Cheung YF. Chylothorax in children after congenital heart surgery. Ann Thorac Surg 2006;82(05):1650-1656   DOI
15 Schild HH, Strassburg CP, Welz A, Kalff J. Treatment options in patients with chylothorax. Dtsch Arztebl Int 2013;110(48):819-826
16 Kovacikova L, Lakomy M, Skrak P, Cingelova D. Immunologic status in pediatric cardiosurgical patients with chylothorax. Bratisl Lek Listy 2007;108(01):3-6
17 Mohan H, Paes ML, Haynes S. Use of intravenous immunoglobulins as an adjunct in the conservative management of chylothorax. Paediatr Anaesth 1999;9(01):89-92   DOI
18 Wasmuth-Pietzuch A, Hansmann M, Bartmann P, Heep A. Congenital chylothorax: lymphopenia and high risk of neonatal infections. Acta Paediatr 2004;93(02):220-224   DOI
19 Cannizzaro V, Frey B, Bernet-Buettiker V. The role of somatostatin in the treatment of persistent chylothorax in children. Eur J Cardiothorac Surg 2006;30(01):49-53   DOI
20 Saxena P, Shankar S, Kumar V, Naithani N. Bilateral chylothorax as a complication of internal jugular vein cannulation. Lung India 2015;32(04):370-374   DOI
21 Yin R, Zhang R, Wang J, et al. Effects of somatostatin/octreotide treatment in neonates with congenital chylothorax. Medicine (Baltimore) 2017;96(29):e7594   DOI
22 Cha HG, Oh TM, Cho MJ, et al. Changing the paradigm: lymphovenous anastomosis in advanced stage lower extremity lymphedema. Plast Reconstr Surg 2021;147(01):199-207   DOI