Recurrent High Output Chyle Fistula Post Neck Dissection Resolution with Conservative Management

2010 ◽  
Vol 120 (S4) ◽  
pp. S141-S141 ◽  
Author(s):  
Samer Al-khudari ◽  
Lisa Vitale ◽  
Tamer Ghanem ◽  
Scott McLean
Keyword(s):  
Neck Dissection ◽  
Conservative Management ◽  
Chyle Fistula ◽  
High Output

Negative-Pressure Vacuum Therapy for High-Output Chyle Leak Following Neck Dissection

2020 ◽  
Vol 15 (5) ◽  
pp. 481-483
Author(s):  
Guy Pines ◽  
Liron Malka Yosef ◽  
Li Or Lazar ◽  
Ilan Bar ◽  
Doron Schindel
Keyword(s):  
Effective Treatment ◽  
Neck Dissection ◽  
Negative Pressure ◽  
Vacuum Therapy ◽  
High Morbidity ◽  
Chyle Leak ◽  
Surgical Interventions ◽  
Vac Therapy ◽  
Chyle Fistula ◽  
High Output

Chyle fistula is a challenging complication following neck dissection carrying a high morbidity and mortality rate. Herein we present a challenging case of successful management of high-output left-sided cervical chyle fistula with negative-pressure vacuum (VAC) therapy in a case where all conservative treatments failed. A 40-year-old man with lymphoma and supraglottic carcinoma underwent endoscopic resection and bilateral neck dissections. He developed high-output chyle fistula, nonresponsive to conservative treatments. Double-layered Vicryl mesh was placed between the sponge and the jugular vein to prevent vascular injury. Immediately after initiation of the VAC therapy, the output decreased, and completely stopped after 3 days. The VAC therapy was continued for additional 5 days to ensure complete seal of the fistula by granulation tissue, by which time the wound was primarily closed. VAC therapy seems to be a safe and effective treatment for high-output cervical chyle fistula following neck dissection, avoiding complex surgical interventions. Thoracic surgeons should be aware of this low-morbidity and potentially effective treatment modality for this challenging complication.

scholarly journals High-output chyle fistula treated with octreotide after neck dissection for papillary thyroid carcinoma

2018 ◽  
Vol 47 (1) ◽  
Author(s):  
Felipe Toyama Aires ◽  
Felipe Augusto Brasileiro Vanderlei ◽  
Raquel Ajub Moyses ◽  
Claudio Roberto Cernea ◽  
Marcos Roberto Tavares
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Neck Dissection ◽  
Papillary Thyroid ◽  
Chyle Fistula ◽  
High Output

Early diagnosis of chyle fistula with SD LipidoCare after neck dissection

2021 ◽  
pp. 1-4
Author(s):  
D H Lee ◽  
H K Kim ◽  
J K Lee ◽  
S C Lim
Keyword(s):  
Conservative Treatment ◽  
Early Diagnosis ◽  
Neck Dissection ◽  
Medical Records ◽  
Test System ◽  
Chyle Fistula

Abstract Objective This study aimed to analyse the results of chyle fistula testing using the SD LipidoCare system in patients who had undergone neck dissections performed in our hospital in 2019. Method Sixty patients who underwent neck dissections from March 2019 to November 2019 were identified based on their medical records. Results Post-operative chyle fistulas were observed in 3 of 60 patients (5 per cent). All patients who developed chyle fistulas had undergone left-sided neck dissections. Within 3 minutes, the SD LipidoCare test had produced triglyceride results of 49, 56 and 207 mg/dl in the three patients. The remaining 57 patients measured ‘low’ for triglycerides on the SD LipidoCare test system. Conclusion The SD LipidoCare test quickly and accurately diagnosed chyle fistulas in patients who had undergone neck dissections. All patients improved with conservative treatment following the early diagnosis of chyle fistulas.

The Successful Conservative Management of High-Output Entero-Cutaneous Fistulae

1973 ◽  
Vol 43 (2) ◽  
pp. 140-143 ◽  
Author(s):  
J. Cocks ◽  
R. Jones ◽  
R. Keknutt ◽  
J. O'Donovan
Keyword(s):  
Conservative Management ◽  
High Output

scholarly journals Use of Octreotide for the Management of Chyle Fistula Following Neck Dissection

2015 ◽  
Vol 141 (8) ◽  
pp. 723 ◽  
Author(s):  
Mark S. Swanson ◽  
Rachael L. Hudson ◽  
Nipun Bhandari ◽  
Uttam K. Sinha ◽  
Dennis R. Maceri ◽  
...  
Keyword(s):  
Neck Dissection ◽  
Chyle Fistula

scholarly journals Conservative Management of Postoperative Chylous Fistula with Octreotide and Peripheral Total Parenteral Nutrition

2017 ◽  
Vol 96 (7) ◽  
pp. 264-267 ◽  
Author(s):  
Jason Y.K. Chan ◽  
Eddy W.Y. Wong ◽  
S.K. Ng ◽  
C. Andrew van Hasselt ◽  
Alexander C. Vlantis
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Neck Dissection ◽  
Conservative Management ◽  
Surgical Intervention ◽  
Case Series ◽  
Somatostatin Analogue ◽  
Left Neck ◽  
Neck Irradiation ◽  
Chylous Fistula

Postoperative chylous fistula after neck dissection is an uncommon complication associated with significant patient morbidity. Octreotide acetate is a somatostatin analogue established in the treatment of chylothorax; however, its utility in the management of cervical chylous fistulae has not been fully evaluated. The investigators hypothesized that chylous fistula can be managed by a combination of octreotide and peripheral total parenteral nutrition (TPN). A retrospective review of cases compiled at our institution from 2009 to 2015 was conducted. Ten patients, all men, were identified as having a postoperative chylous fistula after a neck dissection. All patients were treated with peripheral TPN. and intravenous octreotide. Mean age of the patients was 63.0 years (range 49 to 82). Five (50.0%) had a neck dissection for the management of metastatic nasopharyngeal carcinoma and had previous neck irradiation. In 8 (80%) patients, chylous fistula occurred in the left neck. Seven (70.0%) of the leaks occurred within the first 2 postoperative days. Eight (80%) leaks were controlled using TPN and octreotide, with 2 (20%) patients requiring surgical intervention. No factors were significant in the successful conservative management of chylous fistulae. One patient with a chylous fistula of 1,800 ml/day was managed successfully without surgical intervention. The results of this case series suggest that chylous fistulae may be managed conservatively with octreotide and TPN. However, long-term evaluation is needed to define if and when surgical intervention is required for control.

scholarly journals Conservative Management of Postoperative Chylous Fistula with Octreotide and Peripheral Total Parenteral Nutrition

2017 ◽  
Vol 96 (7) ◽  
pp. 264-267 ◽  
Author(s):  
Jason Y.K. Chan ◽  
Eddy W.Y. Wong ◽  
S.K. Ng ◽  
C. Andrew van Hasselt ◽  
Alexander C. Vlantis
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Neck Dissection ◽  
Conservative Management ◽  
Surgical Intervention ◽  
Case Series ◽  
Somatostatin Analogue ◽  
Left Neck ◽  
Neck Irradiation ◽  
Chylous Fistula

Postoperative chylous fistula after neck dissection is an uncommon complication associated with significant patient morbidity. Octreotide acetate is a somatostatin analogue established in the treatment of chylothorax; however, its utility in the management of cervical chylous fistulae has not been fully evaluated. The investigators hypothesized that chylous fistula can be managed by a combination of octreotide and peripheral total parenteral nutrition (TPN). A retrospective review of cases compiled at our institution from 2009 to 2015 was conducted. Ten patients, all men, were identified as having a postoperative chylous fistula after a neck dissection. All patients were treated with peripheral TPN and intravenous octreotide. Mean age of the patients was 63.0 years (range 49 to 82). Five (50.0%) had a neck dissection for the management of metastatic nasopharyngeal carcinoma and had previous neck irradiation. In 8 (80%) patients, chylous fistula occurred in the left neck. Seven (70.0%) of the leaks occurred within the first 2 postoperative days. Eight (80%) leaks were controlled using TPN and octreotide, with 2 (20%) patients requiring surgical intervention. No factors were significant in the successful conservative management of chylous fistulae. One patient with a chylous fistula of 1,800 ml/day was managed successfully without surgical intervention. The results of this case series suggest that chylous fistulae may be managed conservatively with octreotide and TPN. However, long-term evaluation is needed to define if and when surgical intervention is required for control.

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