This study showed that the cephalic vein cut-down approach for TICVAD implantation reduced complications. Preoperative ultrasonography resulted in a shorter operating time and higher completion rate.

Red Cross Nagasaki Genbaku Hospital We herein report a case developing chylous fistula after partial resection of the left beast and sentinel node biopsy. The patient was a 65-year-old woman who visited our hospital with a chief complaint of a left breast tumor. Breast cancer was suspected based on care needle biopsy findings and left breast partial resection and sentinel node biopsy were thus performed. The patient had an uneventful course and the drain was removed at 2 days after the operation. The diagnosis was spindle cell carcinoma, T2N0M0, ER (-), PgR (-), and HER2 (-). On postoperative day 9, she visited the hospital complaining of bloating at the wound site and 190 mL of white liquid were aspirated. Chylous fistula was diagnosed due to the triglyceride level of 819. As the condition did not improve with a fat-restricted diet and intermittent drainage, the drain was placed again at 49 days after the operation. As the leakage site was observed in the breast under the skin (immediately below the dermis), a closed drain was placed after ligation. The patient then fasted and received a high-caloric infusion. At 12 days after drain placement, there was no fluid drainage and the patient started to have meals ; the drain was removed at 19 days after placement. As there are no reports of postoperative chylous fistula development in the breast after sentinel node biopsy, this was considered to be a rare case in which the leakage site was determined to be subcutaneous.

No abstract