Postoperative chylous fistula prevention and management

Crumley, Roger L.; Smith, James D.

doi:10.1288/00005537-197606000-00008

Cited by 162 publications

(194 citation statements)

References 5 publications

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“…The most risky procedure is ND, in particular radical ones which is accompanied by chylorrhoea in 1-2%, in 75% on the left [1,2]. Also risky is total thyroidectomy [3], subclavian vein cannulation or injury.…”

Section: Discussionmentioning

confidence: 99%

Negative Pressure Wound Therapy in the Treatment of Chylousfistula after Neck Dissection

2016

ARC Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

Negative Pressure Wound Therapy in the Treatment of Chylousfistula after Neck Dissection

2016

ARC Journal of Surgery

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“…It is important to distinguish the patient with hypocalcaemia whose serum calcium can be normal occasionally from the entity that has surfaced more recently in which the serum calcium is always normal. [12][13][14][15] The old literature, in fact, described some cohorts as "normocalcemic", while more careful inspection has shown that these patients were intermittently normocalcemic. [16][17][18][19][20] The incidence of permanent hypocalcaemia which required calcium supplementation was more accurate with serial calcium estimation than the intact parathyroid hormone (iPTH) levels obtained after total thyroidectomy.…”

Section: Discussionmentioning

confidence: 99%

Identification of patients at high risk for hypocalcemia after total thyroidectomy with serial calcium estimation and intact parathyroid hormone levels-a comparative study

Pauly

Santhosh

et al. 2016

Int J Res Med Sci

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“…Delayed surgery can be however complicated by the granulation, adhesion and make the identification of the structures very difficult. Crumley and Smith recommended 500 ml/24h for more than 4 days to be an indication for surgery (16) while Spiro set the borderline at 600 ml (17). Recently thoracoscopic management of cervical thoracic duct injuries has been suggested though its role is still to be evaluated (9).…”

Section: Treatmentmentioning

confidence: 99%

Cervical Chyloma After Thyroidectomy - Two Case Reports and Review of the Literature

Kobiela¹,

Proczko-Markuszewska²,

Stefaniak³

et al. 2009

Polish Journal of Surgery

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2Kierownik: saxon J. connor MD, F.R.A.C.S Thoracic duct injuries are a rare complication of thyroid surgery. This report documents two cases of thoracic duct injury complicated by formation of chyloma following thyroid surgery. The injury was identified post-operatively and treated successfully. We review the diagnostic and therapeutic options and discuss their applicability to our patients. Key words: thyroidectomy, chyle leak, chyloma, thyroid cancer, complication Thyroid surgery is one of the most common procedures performed in endocrine surgery.Complications of this procedure are rare, however, their frequency can increase in thyroid cancer patients. Detailed knowledge of both the common and rare complications allows a surgeon to adequately inform their patient about the risks of this surgery. Such knowledge also allows appropriate preventative measures to be undertaken. The complications include hypoparathyroidism (1.7%), recurrent laryngeal nerve injury causing vocal cord palsy (1%), superior laryngeal nerve injury with subsequent creation of a higherpitched sound and swallowing disturbances (3.7%), haemorrhage with tracheal compression (1.2%), and wound infection (0,3%) (1). Case reports of rare complications, such as damage of the sympathetic trunk, thoracic duct or other structures in this area (such as large veins) are reported occasionally. These complications are often related to technical problems and neoplastic infiltration. CASE REPoRTS 1. A 63 year old lady presented to her general practitioner with pain in the neck radiat- PoLSKI PRZEGLĄD CHIRURGICZNY 10.2478/v10035-009-0039-4 2009 ing to both ears and associated with hoarseness. Physical examination revealed a hard nodule palpable in the left lobe of the thyroid. Ultrasound examination confirmed a 4 cm hypoechogenic nodule and a fine needle biopsy revealed papillary cancer. There was no significant past medical history and the patient, therefore, qualified for radical surgery in our department.The operation was carried out under general anaesthesia. The superior and inferior thyroid poles of the left lobe were ligated following visualisation of recurrent laryngeal nerve and parathyroids. Both lobes were removed en-bloc. During exploration, enlarged lymph nodes were found in the region of the left inferior thyroid artery. An intraoperative frozen section confirmed the diagnosis of papillary cancer with metastatic spread to the ipsilateral lymph nodes. The jugular vein and carotid artery were carefully dissected out and selective neck dissection was performed. No metastatic lymph nodes were identified on the contralateral side. A single drain was placed into the thyroid bed. The specimen was sent for histopathological evaluation that revealed 10 lymph nodes ranging from 0.1 to 1 cm in diameter all with features of reactive lymphadenitis.

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Postoperative chylous fistula prevention and management

Cited by 162 publications

References 5 publications

Negative Pressure Wound Therapy in the Treatment of Chylousfistula after Neck Dissection

Negative Pressure Wound Therapy in the Treatment of Chylousfistula after Neck Dissection

Identification of patients at high risk for hypocalcemia after total thyroidectomy with serial calcium estimation and intact parathyroid hormone levels-a comparative study

Cervical Chyloma After Thyroidectomy - Two Case Reports and Review of the Literature

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