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Zentralbl Chir 2019; 144(S 01): S24-S30
DOI: 10.1055/a-0831-2649
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Chylothorax: eine Übersicht über aktuelle therapeutische Möglichkeiten

Chylothorax: Current Therapeutic Options
Hans Heinz Schild
Radiologische Klinik, Universitätsklinikum Bonn, Deutschland
,
Claus Pieper
Radiologische Klinik, Universitätsklinikum Bonn, Deutschland
› Author Affiliations
Further Information

Publication History

Publication Date:
22 February 2019 (online)

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Zusammenfassung

Die Möglichkeiten der Chylothoraxbehandlung sind in den letzten Jahren durch interventionell-radiologische Möglichkeiten erweitert worden. Insbesondere mit der perkutanen Ductus-thoracicus-Embolisation bestehen mittlerweile größere Erfahrungen. Dennoch sind diese Therapieoptionen nur wenig bekannt und werden auch in aktuellen Veröffentlichungen über den Chylothorax nur wenig oder gar nicht dargestellt. Dies war Anlass, die aktuellen Therapieoptionen einmal vergleichend darzulegen. Das Für und Wider der verschiedenen Behandlungsmöglichkeiten wird anhand der aktuellen Literatur diskutiert. Nach derzeitigem Erfahrungsstand ist das interventionell-radiologische Vorgehen mit geringerer Morbidität und Mortalität belastet als operative Maßnahmen. Die interventionelle Behandlung sollte daher heute in die differenzialtherapeutischen Überlegungen einbezogen werden. Unstrittig indiziert ist ein interventionelles Vorgehen bei operativen Therapieversagern, da diese interventionell sehr häufig erfolgreich behandelt werden können, sowie bei nicht operablen Patienten.

Abstract

Therapeutic options in management of chylothorax encompass conservative, surgical and also interventional measures. Despite the fact that interventions have been performed in substantial numbers of patients – particularly thoracic duct embolisations – general knowledge about this therapeutic option is still limited. Therefore, this article gives an overview of the state of the art for therapeutic options, also emphasising radiological/interventional procedures. At present, interventional treatment has lower morbidity and mortality, and is especially indicated after failed surgical therapy, or in inoperable patients.

Schlüsselwörter

Chylothorax - Intervention - postoperative Komplikation - Behandlung - Thoraxchirurgie

Key words

chylothorax - intervention - postoperative complication - treatment
 

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