Thoracoscopic Treatment of Chylothorax

Chylothorax (CTX), the accumulation of chylous fluid in the pleural space, is a rare condition in children. CTX should be suspected in a child when X-ray or ultrasound of the chest shows pleural effusion, especially after a thoracic operation. The diagnosis is based upon laboratory analysis of pleural fluid. A novel classification for paediatric CTX (pCTX) is proposed in this chapter, to better define the severity of pCTX and to facilitate comparison between therapeutic study outcomes. Regarding the management of CTX in infants and children, there is at present no evidence-based consensus. Different treatment algorithms have been proposed and will be discussed. Depending on the age of the child, the mechanism, type and severity of pCTX, a patient-tailored approach is suggested, with a crucial role for minimal invasive surgical treatment. The advantages of a thoracoscopic approach and different thoracoscopic techniques for the treatment of pCTX are described and discussed.