Current treatment of chylothorax: a case series and literature review.

All cases of chylothorax occurring over a 15-year period in the teaching hospitals of a large Texas medical school were reviewed. This series of 12 patients indicated that chylothorax is a rare event that can be successfully approached with nonoperative therapy for several weeks provided the nutritional and metabolic status of the patients are not adversely affected. Thoracostomy with tetracycline pleurodesis was used in several patients but did not appear to be superior to thoracostomy alone. The surgical experience in this series was limited, but the occasional need for surgical intervention is reviewed. This series suggested that aggressive nonoperative therapy including nutritional manipulation can result in a low mortality when it is followed by surgical intervention if no evidence of resolution of chylothorax occurs.