The Pulmonology Department of the Tel Aviv Medical Center Ichilov offers a full range of highly accurate diagnostic studies and effective treatment methods for lung and respiratory diseases, including chylothorax. The department has a modern lung function diagnostic laboratory that allows for precise assessment of the patient's condition and selection of the optimal treatment strategy. The therapeutic concept is based on an individualized comprehensive approach to each patient. The department is headed by Dr. Yehuda Schwartz.
Whenever possible, doctors try to achieve patient recovery using conservative methods and minimally invasive interventions. In severe cases, extensive surgical interventions are performed in close collaboration with thoracic surgeons. The department also offers specialized intensive therapy, which always receives positive feedback.
About the Disease
Chylothorax is a rare condition in which lymphatic fluid leaks into the space between the lung and the chest wall. When this fluid accumulates in the lungs, it can cause severe coughing, chest pain, and difficulty breathing.
This group of diseases is characterized by impaired circulation of lymphatic fluid. Lymphatic vessels transport lymphatic fluid to the veins, where it returns to the bloodstream, playing a crucial role in immune function and the transport of fats and proteins.
Trauma to the thoracic duct (the main lymphatic vessel), congenital anomalies, or excessively high venous pressure are the main causes of lymphatic flow problems and leakage of lymphatic fluid into the thoracic cavity, abdominal cavity, or other body cavities.
Treatment Methods for the Disease
Treatment of chylothorax depends on its cause. At Ichilov Clinic, patients are treated by a team of experts specializing in lymphatic imaging and interventions.
Conservative Treatment
The cornerstone of treatment is adequate replenishment of fluids and electrolytes, as well as appropriate nutrition. As part of the initial conservative treatment, an attempt is made to reduce the flow of lymph through the thoracic duct to such an extent that the lymph leakage stops, and the chylothorax eventually heals. The patient is prescribed a diet containing medium-chain triglycerides (MCT), which are absorbed directly into the portal vein system without passing through the lymphatic vessels of the intestine and thoracic duct. In addition to the diet, lymphatic flow is reduced using medications that utilize somatostatin or its analogue octreotide.
Surgical Methods
Lymphatic leaks are closed using two similar interventional lymphatic procedures:
Embolization of the Thoracic Duct
A procedure in which the entire thoracic duct is embolized or closed.
Selective Embolization of Lymphatic Ducts
A more targeted procedure in which only specific ducts are embolized, sparing the thoracic duct.
Unlike thoracic duct embolization, where the entire thoracic duct is occluded, in selective lymphatic duct embolization, doctors will target intervention in a specific lymphatic duct or group of ducts that have been identified by lymphangiography as abnormal leaking vessels. This procedure preserves the thoracic duct.
During thoracic duct embolization or selective lymphatic duct embolization, several different types of embolic agents are used. These agents, which include tiny metallic coils, oily contrast agents, or special glue, are introduced through a catheter to stop the leakage and close the abnormal lymphatic vessels.
How Diagnostics Are Conducted
Typically, the entire diagnostic process at Ichilov Clinic occurs in three stages and takes an average of three days. To avoid waiting for the patient, the diagnostic schedule is planned in advance, even before arriving at the clinic.
On the first day, a consultation with the treating pulmonologist is conducted. The doctor performs a physical examination, clarifies the symptoms and signs of the disease, reviews the medical documentation and patient history, and decides what additional studies the patient will need.
The entire second day is devoted to laboratory and instrumental diagnostics. To make an accurate diagnosis, exclude or confirm other conditions that provoke the identified symptoms, the following types of studies are assigned.
- Blood tests.
- Imaging: chest X-ray and ultrasound, CT, MRI of the chest are used to confirm pleural fluid, as well as to determine the location and measure the size of the effusion.
- MR lymphangiography: a method used to determine the exact site of lymphatic leakage.
- Drainage sample: chylothorax is characterized by an increase in leukocyte count and triglyceride levels when taking a drainage sample.
The final stage of any diagnostics at Ichilov Clinic is a medical council, where specialists from related disciplines collectively decide on the choice of treatment protocol that best corresponds to the clinical picture of the disease. At this stage, the overall prognosis is also determined.
- Computed Tomography
- Magnetic Resonance Imaging (MRI)
- X-ray
How Much Does Treatment of Chylothorax Cost at Ichilov
The cost of treatment always consists of the cost of all medical and diagnostic procedures and consultations necessary for the patient. The full scope of required interventions becomes clear upon completion of the diagnostic program. It is at that time that the exact cost is announced.
An approximate price for treatment can be calculated even before the patient arrives at the clinic upon request, which can be made online or by phone as indicated on the website.
In any case, the course of treatment at the Israeli Ichilov Clinic will cost the patient less than similar treatment at a clinic of comparable class in Germany or the USA. On average, a patient can save between 30 to 50% of financial resources considering accommodation costs.
Advantages of Treatment at Ichilov
- The specialists at the clinic have many years of experience treating particularly complex cases of lung diseases, and patients from all over the world come to Ichilov.
- In addition to providing world-class medical services, Ichilov doctors individualize each treatment program with compassion and attention to the unique needs of the individual – physical, psychological, and social.
- The clinic is equipped with modern medical and diagnostic equipment that enhances the effectiveness of therapy.
- Prices for treatment at the clinic are affordable, payment is made at the clinic's cash desk upon receipt of medical services, without prepayments.