{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T05:00:04Z","timestamp":1781240404242,"version":"3.54.1"},"reference-count":16,"publisher":"Korean Pediatric Society","issue":"11","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-cep.org"],"crossmark-restriction":true},"short-container-title":["Clin Exp Pediatr"],"published-print":{"date-parts":[[2025,11,15]]},"abstract":"<jats:p>Background: Pediatric chylothorax poses management challenges, with conservative treatment as the first-line approach and surgery reserved for persistent cases. However, data remain limited on factors related to conservative treatment success and optimal surgical timing.Purpose: This study aimed to evaluate the success rate of conservative treatment, identify the associated factors, and determine the optimal timing for surgical intervention.Methods: We retrospectively reviewed pediatric chylothorax cases at Siriraj Hospital treated between January 2012 and December 2022. Clinical and laboratory parameters, treatment modalities, and outcomes were analyzed.Results: Thirty pediatric patients were included (median age, 1.7 months); 67% were male. Conservative treatment had an overall success rate of 83.3% (25 of 30) and a 95% (19 of 20) success rate among patients with chylothorax after congenital heart disease surgery. Among the factors associated with successful conservative treatment, chylothorax caused by surgery was associated with a significantly higher success rate than nonsurgical causes (91.7% vs. 50%, respectively; P=0.04). The successful group exhibited a significantly lower peak pleural fluid flow rate than the unsuccessful group (26.8 mL\/kg\/day vs. 91 mL\/kg\/day, P=0.002). A time-to-event analysis showed that the success rate of conservative treatment for postsurgical chylothorax was 78% at 14 days, suggesting that 2 weeks may be the optimal timing for surgical intervention.Conclusion: Conservative treatment is an effective first-line treatment for pediatric chylothorax. The etiology and peak flow rate of pleural fluid drainage are associated with its success. Optimized surgical intervention timing is crucial for improving outcomes.<\/jats:p>","DOI":"10.3345\/cep.2025.00598","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T01:56:08Z","timestamp":1762134968000},"page":"871-878","update-policy":"https:\/\/doi.org\/10.3345\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Success rates of conservative treatment and optimal surgical timing for pediatric chylothorax"],"prefix":"10.3345","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7652-7945","authenticated-orcid":true,"given":"Pakwan","family":"Kaewchusen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3291-6470","authenticated-orcid":true,"given":"Narumon","family":"Densupsoontorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0062-3040","authenticated-orcid":true,"given":"Supaluck","family":"Kanjanauthai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3651-5079","authenticated-orcid":true,"given":"Puthita","family":"Saengpanit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1897","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-2072"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2009.06.008"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2000.104287"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2019.00258"},{"key":"ref5","first-page":"182","volume-title":"Management of chylothorax and chylopericardium in pediatric patients: experiences at Siriraj Hospital, Bangkok","author":"Densupsoontorn","year":"2005"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-22-474"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2006.03.039"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9610(05)81195-x"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2007.10.024"},{"key":"ref10","first-page":"53","volume-title":"Congenital chylothorax: current perspectives and trends","author":"Krishnamurthy","year":"2017"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3390\/nu14091803"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1017\/s1047951122001871"},{"key":"ref13","volume-title":"Thai National Growth Charts [Internet]","author":"Bureau of","year":"2021"},{"key":"ref14","first-page":"154","volume-title":"Chylothorax - modalities of management and outcomes: a case series","author":"Pulle","year":"2021"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1111\/ped.15043"},{"key":"ref16","first-page":"e13811","volume-title":"Post-operative chylothorax in children undergoing congenital heart surgery","author":"Ahmed MA","year":"2021"}],"container-title":["Clinical and Experimental Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-cep.org\/upload\/pdf\/cep-2025-00598.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-cep.org\/journal\/view.php?doi=10.3345\/cep.2025.00598","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-cep.org\/upload\/pdf\/cep-2025-00598.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T01:56:17Z","timestamp":1762134977000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-cep.org\/journal\/view.php?doi=10.3345\/cep.2025.00598"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,15]]},"references-count":16,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"URL":"https:\/\/doi.org\/10.3345\/cep.2025.00598","relation":{},"ISSN":["2713-4148"],"issn-type":[{"value":"2713-4148","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,15]]},"assertion":[{"value":"2025-03-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-06","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-15","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}