Severe cervical chyle fistula after radical neck dissection

Rollón, Ángel; Salazar, Ci.; Mayorga, Francisco; Marin, Romela; Infante, P.

doi:10.1016/s0901-5027(06)80031-7

Cited by 22 publications

(20 citation statements)

References 14 publications

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“…However, in our study, we had a higher frequency of endings in the internal jugular vein and a lower frequency for the jugular-venous angle or the subclavian vein. The anatomical variations of the TD are of importance for avoiding injury (most frequently chylothorax or chylous fistula) during surgical procedures such as radical neck dissection (Frazell et al, 1951;Slaughter and Southwick, 1955;Rollon et al, 1996), esophageal resection and construction (Bolger et al, 1991;Paul and Bueno, 2003;Parekh and Iannettoni, 2007;Lai et al, 2011), subclavian vein catheterization (Khalil et al, 1972;Ruggiero and Caruso, 1985), and cannulation of the lymphatic vessels (Shafiroff and Kau, 1959). Chylothorax is a rare complication but may have fatal consequences.…”

Section: Discussionmentioning

confidence: 99%

Anatomical variations in distal portion of the thoracic duct—A systematic review

et al. 2019

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The objective of this study was to identify and analyze the anatomical variations in the termination of the thoracic duct (TD) in cadavers or patients by anatomical dissections and surgical or radiological procedures for better knowledge of the interindividual variations through a systematic review. The search strategy included PubMed and reference tracking. Studies were identified by searching the electronic Medline databases. The search terms included “TD,” “Jugular Vein,” “Subclavian Vein,” or “Cervical,” and the protocol used is reported herein. These search results yielded 20 qualitative review articles out of the 275 articles consulted. We collected all the important data from these 20 articles with 1,352 TD analyzed by varying sources in our search. Regarding the characteristics of the studies and the anatomy of the TD, the results were heterogeneous. The TD most commonly terminates in the internal jugular vein in 54.05% of cases (95% confidence interval [CI]: 54.03; 54.07), in the jugular‐venous angle in 25.79% (95% CI: 25.77; 25.81), and in the subclavian vein in 8.16% of cases (95% CI: 8.14;8.18). Other terminations were found in 12% of cases. This systematic review provided an overview of the variations in the distal portion of the TD. This study can be helpful for surgeons in selecting the most appropriate methods to achieve successful surgical results and avoid complications, such as chylothorax; it also offers detailed information on the cervical termination of the TD in new diagnostic and therapeutic methods involving the TD. Clin. Anat. 32:99–107, 2019. © 2019 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Anatomical variations in distal portion of the thoracic duct—A systematic review

et al. 2019

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“…Most authors suggest conservative treatment and a lowfat diet supplemented with medium-chain triglycerides [427], [449], [452], [453], [454], [455], [456], [457], [458], [459], [460], [461]. Only few authors suggest surgical revision generally [462] or in case of hypoalbuminemia, duration more than 30 days or a daily amount of more than 600 ml [427], [432], [453], [454], [456], [463], [464], [465]. Nussenbaum suggests surgical revision if more than 1000 ml are drained within the first 24 hours [466].…”

Section: Discussionmentioning

confidence: 99%

Malpractice claims and unintentional outcome of tonsil surgery and other standard procedures in otorhinolaryngology

Windfuhr

2013

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 12:Doc08; ISSN 1865-1011

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“…Chylous fistula can sometimes be a severe and lethal complication because of persistent fluid drainage of more than 1,000 mL per day. 2,3,17 For our first application of NPWT for chylous fistula, we selected relatively low pressure (À50 mm Hg) because there were concerns about an unexpected increase in drainage due to negative pressure. However, contrary to our concern, the amount of drainage decreased after the first day of NPWT, and the fistula was closed within 6 days.…”

Section: Discussionmentioning

confidence: 99%

Management of chylous fistula after neck dissection using negative‐pressure wound therapy: A preliminary report

2012

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Chylous fistula is a distressing complication resulting from thoracic duct injury during neck dissections. We have successfully managed chylous fistula using negative-pressure wound therapy (NPWT) in a case where all conservative treatments failed. A 60-year-old man with tongue cancer underwent subtotal glossectomy and bilateral neck dissections. On postoperative day 4, a chylous fistula with large drainage developed in the right neck. Conservative treatments were not effective, therefore, NPWT was started from postoperative day 9. The drainage volume then began to decrease, and the chylous fistula was closed 6 days after starting NPWT. In our case, the effects of wound shrinkage and fluid removal by NPWT were considered to contribute to early closure. Although preliminary, NPWT can be an important treatment choice for the management of a chylous fistula after neck dissections.

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Severe cervical chyle fistula after radical neck dissection

Cited by 22 publications

References 14 publications

Anatomical variations in distal portion of the thoracic duct—A systematic review

Anatomical variations in distal portion of the thoracic duct—A systematic review

Malpractice claims and unintentional outcome of tonsil surgery and other standard procedures in otorhinolaryngology

Management of chylous fistula after neck dissection using negative‐pressure wound therapy: A preliminary report

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