scholarly journals AB007. 86. Thoracoscopic ligation of the thoracic duct for cervical chyle leak following radical neck dissection

2018 ◽  
Vol 2 ◽  
pp. AB007-AB007
Author(s):  
Michael Flanagan ◽  
Antonios Athansiou ◽  
Thomas Murphy
Keyword(s):  
Neck Dissection ◽  
Thoracic Duct ◽  
Radical Neck Dissection ◽  
Chyle Leak

scholarly journals Management of Chyle Leak in the Neck Following Thyroid Cancer Surgery: A Single Center Experience

2015 ◽  
Vol 7 (1) ◽  
pp. 6-9 ◽  
Author(s):  
Deepak Thomas Abraham ◽  
Anish Cherian ◽  
Mazhuvanchary Jacob Paul
Keyword(s):  
Thyroid Cancer ◽  
Neck Dissection ◽  
Thoracic Duct ◽  
Cancer Surgery ◽  
Safe Procedure ◽  
Single Center ◽  
Chyle Leak ◽  
Single Center Experience ◽  
Thoracic Duct Injury ◽  
Combination Of Methods

ABSTRACT Introduction Surgery for thyroid cancers often necessitates a neck dissection. This is usually a safe procedure, but can be associated with complications. Chyle leak is one such complication, fortunately rare. There is a dearth of literature with regard to the management of chyle leak in the neck. We present a single center experience in the management of chyle leak in the neck, to improve the understanding of its management. Materials and methods A retrospective analysis of patients with thyroid cancer, managed between January 1st 2005 and December 31st 2011, in a single institution was performed. Among these, patients with chyle leak were identified. All pertinent data collected and results analyzed using STATA (v10). Results Three hundred and seventy-three/eight hundred and twenty-one (45.4%) patients surgically managed for thyroid cancer underwent a neck dissection. Thoracic duct injury was recog- nized and managed intraoperatively in 20/373 (5.4%) patients. The leak was prevented in the majority (66.6%) of patients in whom a combination of methods were employed. 25/373 (6.7%) patients were diagnosed and managed for chyle leak postoperatively. Seven patients required re-exploration. This included patients with low output chyle leaks who may have settled in a week to 10 days with conservative management. A combination of techniques was successful in the majority (71.4%). The remaining patients were successfully managed conservatively. Conclusion We conclude that using a combination of methods to manage thoracic duct injury may be better than using a single modality alone. Early re-exploration was more economical and acceptable for a subset of our patients, as they come from long distances at personal cost. How to cite this article Cherian a, Ramakant P, Paul MJ, Abraham DT. Management of Chyle Leak in the Neck Following Thyroid Cancer Surgery: A Single Center Experience. World J Endoc Surg 2015;7(1):6-9.

scholarly journals Persistent chyle leak following radical neck dissection: a solution that can be the solution

2005 ◽  
Vol 87 (5) ◽  
pp. 379-379 ◽  
Author(s):  
John C Muthusami ◽  
John P Raj ◽  
D Gladwin ◽  
Pranay Gaikwad ◽  
Shalom Sylvester
Keyword(s):  
Neck Dissection ◽  
Radical Neck Dissection ◽  
Chyle Leak

scholarly journals CRITICAL EVALUATION OF COMPLICATIONS OF NECK DISSECTION

2019 ◽  
pp. 1-3
Author(s):  
Ahmad Rizvan
Keyword(s):  
Head And Neck Cancer ◽  
Neck Dissection ◽  
Reliable Method ◽  
Skin Flap ◽  
Radical Neck Dissection ◽  
Critical Evaluation ◽  
Main Trunk ◽  
Chyle Leak ◽  
Marginal Mandibular Nerve ◽  
Substantial Morbidity

BACKGROUND: Radical neck dissection is a reliable method of treating patients with head and neck cancer; it carries substantial morbidity and complications. This surgery has become a routine in many oncological centres but knowledge of possible complications and their management is a must for treating surgeons METHODS: In this study 60 patients undergoing neck dissection as elective or therapeutic, comprehensive or selective, as a sole procedure or combined with other surgery, with or without other modalities of treatment were selected and managed and all the complications were critically analysed. RESULTS: A total of 26 complications (43.3%) occurred in this study. There were 7 cases of thoracic duct injury (11.6%), 5 cases of post operative chyle leak (8.3%) and 2 cases of RLN injury (3.3%) and 1 case of injury to main trunk of facial nerve (1.6%), 2 patients had temporary paresis of marginal mandibular nerve (3.3%). Post operatively marginal necrosis of skin flap was present in 8 patients (13.3%) and 1 patient had facial and glottic oedema (1.6%). CONCLUSION: Despite the best planning, complications can still occur but their impact can be minimised by a vigilant and proactive emphasis in the entire peri-operative period.

scholarly journals Bilateral Chylothorax Following Left Neck Dissection and Literature Review

2021 ◽  
Author(s):  
Sachiko Kimizuka ◽  
Hiroyuki Yamada ◽  
Koji Kawaguchi ◽  
Toshikatsu Horiuchi ◽  
Akira Takeda ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Neck Dissection ◽  
Thoracic Duct ◽  
Radical Neck Dissection ◽  
Clinical Findings ◽  
Cough Reflex ◽  
Low Fat Diet ◽  
Bilateral Chylothorax ◽  
Left Neck ◽  
Chyle Leakage

Abstract Background: Although chyle leakage may occur in the neck when the thoracic duct is damaged during cervical dissection, it is extremely rare for the chylothorax alone to leak chyle into the thoracic cavity. Case presentation: We report a case of bilateral chylothorax without chyle cervical leakage after left neck dissection, wherein partial left upper jaw resection and left radical neck dissection were performed in a 46-year-old woman who was diagnosed with left upper gingival cancer. The thoracic duct was ligated and cut during surgery and, although no obvious leakage of lymph was observed, dyspnea and cough reflex during deep inhalation were observed from the 3rd postoperative day. Approximately 600 mL of yellowish-white pleural effusion was aspirated during bilateral thoracentesis, and chylothorax was diagnosed based on clinical findings and biochemical analysis results. The patient was put on a low-fat diet on the 4th postoperative day, and a total of 3 neck drains were removed 8 days after the operation. Conclusions: Pleural effusion disappeared on imaging examination 16 days after thoracentesis and 5 years and 6 months have passed since the operation. At this time, there has been no evidence of tumor recurrence, metastasis, or pleural effusion.

Lymphatic Drainage System after Left Radical Neck Dissection

1994 ◽  
Vol 103 (1) ◽  
pp. 46-48 ◽  
Author(s):  
Gady Har-El ◽  
Frank E. Lucente
Keyword(s):  
Pleural Effusion ◽  
Neck Dissection ◽  
Thoracic Duct ◽  
Lymphatic Vessel ◽  
Lymphatic System ◽  
Radical Neck Dissection ◽  
Drainage System ◽  
Lymphatic Drainage ◽  
Venous System ◽  
Collateral System

The thoracic duct is the main lymphatic vessel that drains most of the body's lymph and all of the intestinal chyle into the venous system. The thoracic duct may be ligated during left radical neck dissection (RND) without any significant sequelae. The lymphatic system must, therefore, have collateral channels. The present study shows an increased incidence of pleural effusion after left RND when compared to right RND. We suggest that this represents the inability of the collateral system to immediately accommodate the increased volume of chyle.

scholarly journals A rare case of abnormally high thoracic duct in neck

2021 ◽  
Vol 8 (7) ◽  
pp. 2247
Author(s):  
Amol Padegaonkar ◽  
Anushree Sehgal ◽  
Shambhunath Agrawal
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neck Dissection ◽  
Buccal Mucosa ◽  
Thoracic Duct ◽  
Rare Case ◽  
Valsalva Manoeuvre ◽  
Significant Morbidity ◽  
Chyle Leak ◽  
Thoracic Duct Injury ◽  
Omohyoid Muscle

Thoracic duct injury can be a cause of significant morbidity if its injury remain undiagnosed during surgery. Knowledge of its course and anomaly should be known to prevent its injury. Presenting a case of 40 year male who was diagnosed to have left buccal mucosa squamous cell carcinoma. During neck dissection, anomalous thoracic duct was found much above the omohyoid muscle. Adequate steps were taken to prevent injury to it. It is necessary to acknowledge thoracic duct and prevent its injury during neck dissection.  Knowledge about its anomalous path should be known to prevent its injury. Valsalva manoeuvre should be done at the end of neck dissection to find and thoracic duct injury by observing chyle leak and adequate measures should be taken immediately to prevent morbidity associated with it.    

scholarly journals Bilateral Chylothorax Following Left Neck Dissection and Literature Review

2021 ◽  
Author(s):  
Sachiko Kimizuka ◽  
Hiroyuki Yamada ◽  
Koji Kawaguchi ◽  
Toshikatsu Horiuchi ◽  
Akira Takeda ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Neck Dissection ◽  
Thoracic Duct ◽  
Radical Neck Dissection ◽  
Clinical Findings ◽  
Cough Reflex ◽  
Low Fat Diet ◽  
Bilateral Chylothorax ◽  
Left Neck ◽  
Chyle Leakage

Abstract BackgroundAlthough chyle leakage may occur in the neck when the thoracic duct is damaged during cervical dissection, it is extremely rare for the chylothorax alone to leak chyle into the thoracic cavity. Case presentationWe report a case of bilateral chylothorax without chyle cervical leakage after left neck dissection, wherein partial left upper jaw resection and left radical neck dissection were performed in a 46-year-old woman who was diagnosed with left upper gingival cancer. The thoracic duct was ligated and cut during surgery and, although no obvious leakage of lymph was observed, dyspnea and cough reflex during deep inhalation were observed from the 3rd postoperative day. Approximately 600 mL of yellowish-white pleural effusion was aspirated during bilateral thoracentesis, and chylothorax was diagnosed based on clinical findings and biochemical analysis results. The patient was put on a low-fat diet on the 4th postoperative day, and a total of 3 neck drains were removed 8 days after the operation. ConclusionsPleural effusion disappeared on imaging examination 16 days after thoracentesis and 5 years and 6 months have passed since the operation. At this time, there has been no evidence of tumor recurrence, metastasis, or pleural effusion.

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