Post-Tonsillectomy Hemorrhage Rates in Children Compared by Surgical Technique

Reusser, Nicole M.; Bender, Robert W.; Agrawal, Nikhil; Albright, James T.; Duncan, Newton O.; Edmonds, Joseph L.

doi:10.1177/014556131709600702

Cited by 29 publications

(36 citation statements)

References 20 publications

(23 reference statements)

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“…The results showed that eight (80%) of 10 patients in low‐output group and four (25%) of 16 patients in high‐output group got resolution of chyle fistula by octreotide therapy in combination with other conservative management. However, the overall success rate of conservative therapy was 46.2% (12/26), which was considerably lower than that described in previous studies (reported range, 80%‐100%) . This may have been due to the high‐output cases with a higher proportion in this study.…”

Section: Discussioncontrasting

confidence: 79%

“…This may have been due to the high‐output cases with a higher proportion in this study. Sixty‐two percent of patients (16/26) had high‐output chyle fistula (>500 mL), while the proportion of high‐output cases in previous studies was 33.3% (4/12), 21.1% (4/19), and 20.0% (2/10), respectively . Therefore, our findings in the present study suggest that octreotide therapy may have a limited effect on high‐output leakage.…”

Section: Discussionsupporting

confidence: 42%

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

Chen

Zou

et al. 2019

Head & Neck

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Background The efficacy of Pseudomonas aeruginosa‐mannose sensitive hemagglutinin (PA‐MSHA) injection therapy in the treatment of chyle fistula following neck dissection is unclear. Methods This prospective study enrolled 26 patients who developed chyle fistula after neck dissection. Patients were divided into high‐output (>500 mL) and low‐output groups (≤500 mL) and were initially treated conservatively for 5 days in the high‐output group or 7 days in the low‐output group. When conservative treatment failed, topical PA‐MSHA therapy was applied. Results Twelve of 26 patients were cured with conservative treatment, and the remaining 14 patients were all successfully resolved by PA‐MSHA therapy. Chyle fistula got resolved in the low‐output and high‐output groups after the initiation of therapy were at a median 1 days and 6 days, respectively. Among them, 12 (85.7%) patients experienced fever and 11 (78.6%) patients experienced neck pain. Conclusions Topical PA‐MSHA injection therapy could effectively manage chyle fistula following neck dissection.

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Section: Discussioncontrasting

confidence: 79%

Section: Discussionsupporting

confidence: 42%

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

Chen

Zou

et al. 2019

Head & Neck

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“…In the article of Sheybani et al, Lipiodol embolization to the brain and to the lung was reported as a CL-related major complication after intranodal CL, and the patient died 69 days after CL (because all supportive care was withdrawn due to a very low probability of meaningful recovery after a complicated clinical course including deteriorating mental status and pneumonia) [29]. Somatostatin is secreted from the pancreas, stomach, and duodenum, and it exerts inhibitory actions on stomach acid and bile secretion, and thus reduces chyle flow by suppressing the absorption of fat, which is the raw material for chyle [47]. This document was downloaded for personal use only.…”

Section: Technical Aspects Of CLmentioning

confidence: 99%

Conventional Lymphangiography (CL) in the Management of Postoperative Lymphatic Leakage (PLL): A Systematic Review

Sommer

Pieper

Itkin³

et al. 2020

Rofo

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Background Postoperative lymphatic leakage (PLL) is usually managed by conservative and/or surgical treatments but these procedures can be challenging to perform and potentially clinically ineffective. Therefore, conventional lymphangiography (CL) has emerged as an important alternative. The aim of this review is to present the available outcome data on CL in the management of PLL. Method A systematic literature search (PubMed) using the MeSH term “lymphangiography” was performed and the search was restricted to literature published between January 2007 and August 2019. Identification, screening, and assessment for eligibility and inclusion were conducted in accordance with PRISMA. Results From the initially obtained 1006 articles (identification), 28 articles with a total of 201 patients were finally included (inclusion). The methodological quality of all included articles corresponds to level 4 (Oxford Centre for Evidence-based Medicine – Levels of Evidence, March 2009). PLL occurs after oncological and non-oncological surgery in the form of chylothorax, chylous ascites, and cervical, thoracic, abdominal and peripheral lymph fistula and/or lymphocele. The technical success rate of CL is 75–100 %. Access for CL is transpedal (176 patients) or intranodal (25 patients). Lipiodol is used as the contrast material in all articles, with a maximum amount of 20 ml for transpedal CL and 30 ml for intranodal CL. The X-ray imaging modalities used for CL are fluoroscopy, radiography and/or CT. Two articles report CL-associated major complications and CL-associated morbidity and mortality. The PLL cure rate is 51–70 % for transpedal CL (time to PLL cure: 2–29 days) and 33–100 % for intranodal CL (time to PLL cure: 2–< 30 days). Bailout procedures in the case of clinically ineffective CL include a range of treatments. Conclusion CL is feasible, safe, and effective in the management of PLL. Lipiodol as the contrast material is essential in CL because the highly viscous iodinated poppy-seed oil has not only diagnostic but therapeutic effects. Guidelines and randomized controlled trials are further steps towards defining the ultimate value of CL. Key Points: Citation Format

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“…Bu çalışmada oktreotidin hem yüksek hem düşük akımlı ŞF'lerde açık bir tedavi etkisi olduğu ve hastanede yatış sürelerini ve morbiditeyi azalttığı görülüyor. Literatürde çalışmamız dışında oktretidin başlangıç tedavisi olarak konservatif tedavide kullanıldığı sadece iki çalışma vardır fakat vaka sayıları çalışmamıza kıyasla nispeten azdır 13,18 . Chan ve arkadaşlarının çalışmasında 13 Oktreotid verilme dozu, yolu ve süresi de çalışmalarda değişkenlik göstermektedir.…”

Section: Gereç Ve Yöntemunclassified

“…Bildiğimiz kadarıyla çalışmamız literatürde oktreotid tedavisinin ŞF tedavisinde etkinliğini değerlendiren çalışmalar içinde en fazla hasta sayısı bulunan çalışmadır. 12,13,18,19 . Oktreotidin ŞF tedavisinde etki mekanizmasının gastrointestinal ve pankreatik salgıları azaltması, hepatik venöz basıncı düşürmesi, splankik kan akımını azaltması sonucu olduğu düşünülmektedir 20 .…”

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Efficacy of octreotide as initial therapy in the treatment of chylous fistula

Dagkiran

2020

Cukurova Medical Journal

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The aim of this study was to investigate the efficacy of octreotide used as initial treatment in patients with low or high flow chylous fistula (CF) after neck dissection. Materials and Methods: Twenty-one patients who underwent neck dissection between 2010-2019 and developed chylous fistula were included in this study. Octreotide was added to the conservative treatment of all patients as initial treatment. Age, gender, surgical indications for neck dissection, type of neck dissection, the duration of CF and octreotid treatment, the amount of chylous fluid in 24 hours, total hospitalization time and treatment-related complications were evaluated. Results: Two patients had CF on the right side and 19 patients on the left side. Intraoperative CF was detected in 52.3% (11/21) of the patients. Thirteen patients had lowflow and 8 patients had high-flow CF. Treatment success was 100% (13/13) in low flow, 62.5% (5/8) in high flow, and 85.71% (18/21) in total. Three patients with high-flow CF required surgical treatment. Mean duration of fistula closure was 4.2 days in patients receiving octreotide without surgical treatment. Only to be low-flow or highflow CP was found as a statistically significant between the group that CP controlled with octreotide treatment and the group required surgery. Conclusion: Our study showed that the addition of octreotide to conservative treatment as an initial treatment in both low-flow and high-flow CF provided successful results.

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Post-Tonsillectomy Hemorrhage Rates in Children Compared by Surgical Technique

Cited by 29 publications

References 20 publications

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

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

Conventional Lymphangiography (CL) in the Management of Postoperative Lymphatic Leakage (PLL): A Systematic Review

Efficacy of octreotide as initial therapy in the treatment of chylous fistula

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