Treatment of chylothorax with elemene

BACKGROUND: Chylothorax is a disorder with a variety of causes and is often difficult and complex to manage. There are two treatment options for chylothorax: conservative management or surgical intervention. Conservative management of chylothorax consists of pleural fluid drainage, supportive ventilation, supplementation of fluid loss, and elemental diet or total parenteral nutrition. Surgical repair often results in significant morbidity and mortality. Pleurodesis is also an appropriate method of treatment. Elemene, an extract of the ginger plant, is also a sclerosing agent and can be used for pleurodesis. METHODS: In this study, 23 consecutive patients were treated for high-output chylothorax. 0.5 % elemene emulsion injection (40 ml) was injected into the pleural cavity. The injection can be repeated if necessary. RESULTS: All patients experienced resolution of symptoms. 7 patients received sclerotherapy with elemene once, 11 patients received it twice and 4 patients received it three times. 1 patient required five applications of elemene. The side effects included chest pain and fever but were considered sustainable. CONCLUSION: Elemene is an effective and safe treatment for patients with chylothorax.