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Ann Thorac Surg 2001;71:450-451
© 2001 The Society of Thoracic Surgeons

Invited commentary

^a Department of Thoracic Surgery and Diseases of the Esophagus, Ste Marguerite University Hospital, 270 Bd Ste Marguerite, F-13274 Marseille, France

e-mail: pfuentes@mail.ap-hm.fr

Postoperative chylothorax remains an uncommon but potentially life-threatening complication of various intrathoracic procedures, and the ideal management of this condition is still controversial. Generally, so-called conservative therapy is tried first, and includes low-fat diet, total parenteral nutrition, and pleural drainage. Somatostatin and more recently Etilefrine [1], a sympathomimetic drug used in the management of postural hypotension, also causing smooth muscle contraction of the thoracic duct, have been reported as significant additives to this regimen. However, it usually takes several weeks for the chylothorax to resolve and it is almost always unsuccessful in patients with high flow leaks. Indeed, it has been clearly demonstrated that a high volume of chylous output could reliably predict the failure of continuing medical treatment . . . [Full Text of this Article]