Management of chyle leakage after thyroidectomy, cervical lymph node dissection, in patients with thyroid cancer

Abstract

The occurrence of chyle leakage after central compartment dissection even without lateral neck dissection was not rare, but was easily controlled with conservative management. Surgical management should be considered if the drainage amount does not decrease by >50% of the original amount of the day of detection after 2 days of NPO.

Pseudomonas aeruginosa‐mannose sensitive hemagglutinin injection therapy for the treatment of chyle fistula following neck dissection

“…Most reported cases involve lateral neck dissection (radical or selective), but can develop following central neck dissection . Previous studies have reported chyle fistula with an incidence of 3.9% to 8.3% after lateral neck dissection . In our study, the overall incidence of chyle fistula following neck dissection was 3.3%, which is slightly lower than that reported in previous studies.…”

“…Chyle fistula following neck dissection is rare, and the incidence varies depending on surgical extent . Most reported cases involve lateral neck dissection (radical or selective), but can develop following central neck dissection . Previous studies have reported chyle fistula with an incidence of 3.9% to 8.3% after lateral neck dissection .…”

“…When chyle fistula develops after neck dissection, it should be managed expeditiously. Conservative management involving bed rest, diet modification, local compressive dressing, and negative‐pressure drainage has been advocated as the initial treatment of choice for low‐ and moderate‐output fistulae . Among them, diet modification consisted of a fat‐free diet, a low‐fat diet, a medium‐chain triglyceride diet, or TPN is the important part of conservative treatment.…”

“…Neck reexploration with attempts at oversewing or ligating the leakage sites has been traditionally considered as the standard treatment for chyle fistula. Although adjunctive measures such as fibrin glue, Surgicel or Gelfoam packing, or muscular flap have been applied to increase the success rate of surgical reexploration, reexploration is usually unsatisfactory . Moreover, reexploration in the postsurgical area tends to be difficult and challenging, and some patients are not suitable for an early reoperation.…”

High‐output chyle leak after breast‐conserving surgery and sentinel lymph node biopsy

“…Postoperative chyle leaks occur secondary to intraoperative lymphatic duct disruption. More commonly described in the head and neck literature, lymphatic injury leading to chyle leak has a reported incidence 0.5%‐8.3% following neck surgery, generally due to thoracic duct injury . Chyle leaks have also been described following major abdominal and pelvic node dissections, pancreatectomy, kidney transplantation, prostatectomy, thoracic, spinal, and gynecological surgery …”