On 2014 May 07, Stefan Pokall commented:

I wonder about the title since the answer is given by the clinical course and the chyle output. What this article adds is a late presentation with 3 months of age without a prenatal or perinatal history. The conclusion that pleuroperitoneal shunt is the first procedure to perform in children is not supported in literature, rather a TDL as demonstrated in cardiothoracic studies by Cleveland K 2009 and Nath DS 2009 and even Azizkhan recommends it secondary to pleurodesis (textbook ziegler/azizkhan/weber Fig.41-5).

On 2014 May 07, Stefan Pokall commented:

I wonder about the title since the answer is given by the clinical course and the chyle output. What this article adds is a late presentation with 3 months of age without a prenatal or perinatal history. The conclusion that pleuroperitoneal shunt is the first procedure to perform in children is not supported in literature, rather a TDL as demonstrated in cardiothoracic studies by Cleveland K 2009 and Nath DS 2009 and even Azizkhan recommends it secondary to pleurodesis (textbook ziegler/azizkhan/weber Fig.41-5).