Chylous pleural effusion treatment

I believe everyone knows about chylous pleural effusion. If this disease is not treated in time, it will cause serious consequences. Good health is the capital of everyone's struggle. Physical illness requires everyone to have a correct understanding and cannot be ignored. You must pay attention to your physical health. You only have one life, so you must constantly protect it. Below we will introduce to you the treatment of chylous pleural effusion.

Once chylothorax is diagnosed, fasting, blood transfusion, intravenous fluid replacement, and high-nutrient support should be adopted immediately. Thoracentesis or closed drainage can fully expand the lungs. Malignant tumors should be treated with radiation therapy. One-half of patients can be treated conservatively, while the other half require surgery.

Conservative treatment methods:

1. Fasting, intravenous fluid replacement, high nutritional support, and closed chest drainage;

2. Use somatostatin to inhibit chylomicron production;

3. Intrathoracic injection of pleural adhesion agents to promote pleural adhesion and close the thoracic duct fistula;

4. After successful treatment, gradually resume normal diet.

Surgical treatment methods:

1. Indications for surgery: acute onset and caused by trauma; progressive increase in pleural effusion and no reduction after onset; generally good condition, not caused by malignant tumor invasion; conservative treatment is ineffective and active surgery should be given.

2. Preoperative preparation: fully correct malnutrition and electrolyte imbalance before surgery, give blood transfusions, high protein, control respiratory tract infections, and give a high-fat diet 3 to 4 hours before surgery to help find the chest duct and its damaged site during surgery.

3. Surgical treatment:

(1) Anesthesia: endotracheal intubation and intravenous combined anesthesia.

(2) The patient is usually in the left-side decubitus position and the surgery is usually performed on the right side; however, the surgery can also be performed on the left side.

(3) Ligate the chest duct through the right posterior lateral incision and enter the chest through the 5th or 6th intercostal space. Aspirate the pleural effusion, push the lung forward, expose the posterior mediastinum, and look for the white, translucent 4-5 mm thick thoracic duct between the azygos vein and the aorta. Double ligate the damaged ends with thick thread, then use gauze to absorb the effusion and carefully observe for leakage.

(4) To ligate the thoracic duct through the left chest, the mediastinal pleura is incised above the aorta, and the thoracic duct is found behind the subclavian artery and double ligated. If the rupture is below the aortic arch, the thoracic duct is found between the azygos vein and the aorta using the right chest approach and ligated.

(5) Except for those caused by invasion and compression of malignant tumors, the patient generally has a good prognosis after proper ligation.

Through the introduction of the above article, we learned the treatment method of chylous pleural effusion. We hope that these methods can help patients recover soon. A healthy body is the most basic condition for realizing your dreams. When you are sick, do not choose to ignore it, but actively cooperate with the treatment. I hope the patient can maintain a positive and happy mood. Follow your doctor's orders. I wish you all a speedy recovery.