日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Background: Lymph flow disorder in the central lymph pathway is referred to as central lymphatic disease. This disorder can be intractable and can present as postoperative chylothorax. Although novel concepts and treatments have been reported, some specialists were generally asked about ideas beyond their specialties. Hence, the current study aimed to validate the ideas that emerged from these consultations.

Material and Methods: We analyzed the consultations handled by our team from May 2016 to May 2020. All data about the location and characteristics of the consulted hospitals, specialty of the consulting physician, and aim of the consultations (operation request, treatment plan, testing details, and nutrition) were retrospectively assessed.

Results: In total, 38 consultations were evaluated. We observed an annual increment in the number of cases. The majority of questioners were in the Kanto region, university hospitals, and pediatric cardiologist, about postoperative chylothorax. Notably, the consultations primarily aimed to discuss treatment plans rather than operative requests.

Conclusion: A standardized therapeutic strategy for central lymphatic disease should be established. Thus, a proposal for such a treatment approach was presented in our strategy flowchart.