OK-432 therapy for chylous pleural effusion or ascites associated with lymphatic malformations


      OK-432 therapy is effective for the treatment of macrocystic lymphatic malformations (LMs), but the optimal management of patients with microcystic LMs associated with large chylous pleural effusions or chylous ascites is not resolved. We performed thoracoscopic- or laparoscopic-guided injection of OK-432 for 2 patients with diffuse microcystic LMs accompanied by refractory chylous pleural effusion or chylous ascites. Both cases responded well to OK-432 therapy with improvement/resolution of fluid collections and associated symptoms. We recommend the use of OK-432 therapy as a promising treatment for microcystic LMs with functionally significant lymphatic fluid collections.

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        • Weinstein L.D.
        • Scanlon G.T.
        • Hersh T.
        Chylous ascites. Management with medium-chain triglycerides and exacerbation by lymphangiography.
        Am J Dig Dis. 1969; 14: 500-509
        • Ogita S.
        • Tsuto T.
        • Tokiwa K.
        • et al.
        Intracystic injection of OK-432: a new sclerosing therapy for cystic hygroma in children.
        Br J Surg. 1987; 74: 690-691
        • Ogita S.
        • Tsuto T.
        • Iwai N.
        • et al.
        OK-432 therapy in 64 patients with lymphangioma.
        J Pediatr Surg. 1994; 29: 784-785
        • Poldervaart M.T.
        • Breugem C.C.
        • Speleman L.
        • et al.
        Treatment of lymphatic malformations with OK-432 (Picibanil): review of the literature.
        J Craniofac Surg. 2009; 20: 1159-1162
        • Aalami O.O.
        • Allen D.B.
        • Organ Jr, C.H.
        Chylous ascites: a collective review.
        Surgery. 2000; 128: 761-778
        • Huang Q.
        • Jiang Z.W.
        • Jiang J.
        • et al.
        Chylous ascites: treated with total parenteral nutrition and somatostatin.
        World J Gastroenterol. 2004; 10: 2588-2591
        • Collard J.M.
        • Laterre P.F.
        • Boemer F.
        • et al.
        Conservative treatment of postsurgical lymphatic leaks with somatostatin-14.
        Chest. 2000; 117: 902-905
        • Cochran W.J.
        • Klish W.J.
        • Brown M.R.
        • et al.
        Chylous ascites in infants and children: a case report and literature review.
        J Pediatr Gastroenterol Nutr. 1985; 4: 668-673
        • Cardenas A.
        • Chopra S.
        Chylous ascites.
        Am J Gastroenterol. 2002; 97: 1896-1900
        • Cheng W.S.C.
        • Gough I.R.
        • Ward M.
        • et al.
        Chylous ascites: a case report and review of the literature.
        J Gastroenterol Hepatol. 1989; 4: 95-99