Percutaneous sclerosing injection to the thoracic duct under CT guidance for cervical chylous leakage post thyroidectomy: A case report

Cương, Nguyễn Ngọc; Hoan, Le; Linh, Le Tuan; Tan, Pham Huy; My, Thieu Thi Tra; Duc, Nguyen Minh

doi:10.1016/j.radcr.2021.06.054

Cited by 1 publication

(1 citation statement)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 4 Patients who had persistent high output or failure of conservative measures required other management approaches such as surgery, thoracic duct embolization, or sclerotherapy. 5 , 6 Lymphatic embolization has been reported as an effective method of managing patients with chylous ascites and chylothorax. 7 , 8 There are some sporadic reports about TDE in management of CL post-thyroidectomy when conservative management is ineffective.…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Treatment of Chyle Leak After Thyroidectomy and Cervical Lymph Node Dissection in Patients with Thyroid Carcinoma: Results of a Study Involving 36 Patients

Cuong,

Hoan,

Tra My

et al. 2024

TCRM

Self Cite

View full text Add to dashboard Cite

Objective Chyle leak (CL) after head and neck surgery is a rare but well-known complication. In patients with high-output leakage, the treatment can be complicated. This study aims to report on a recent innovation in lymphatic intervention for treating such patients. Materials and Methods A retrospective review of 36 patients with chyle leak after neck surgery for thyroid cancer was conducted to assess the efficacy of percutaneous lymphatic embolization and thoracic duct (TD) disruption. Results Antegrade catheterization of the thoracic duct was achieved in 31 of 36 patients (86.1%). Therefore, embolization of the thoracic duct and thoracic duct branches was performed in 26 and 5 patients, respectively. In 5 cases of unsuccessful antegrade catheterization into the thoracic duct, transcervical access embolization was performed in 2 patients, and TD disruption (TDD) was performed in 3 patients. The pooled overall technical success rate of lymphatic embolization was 33/36 patients (91.7%). One patient who underwent thoracic duct embolization (TDE) with technical success (1/33 patients) but clinical failure had additional treatment directly sclerosing the TD under computed tomography scan. Cervical fluid collection sclerotherapy was done in 7 patients as an additional treatment. Resolution of the chyle leak after procedures was observed in all patients (100%). The mean time to resolution was 3 days (1–7 days). There was no complication intra and after procedures. Conclusion TDE, selective TD branches embolization and TDD are safe and effective minimally invasive treatments for CL post-surgery for thyroid carcinoma. Sclerosing cervical fluid collection contributes to clinical success.

show abstract