Usefulness of thoracic duct clipping in thoracoscopic surgery for chylous fistula occurring after neck dissection

2013 ◽  
Vol 3 (3) ◽  
pp. 158-160 ◽  
Author(s):  
Soichiro Takase ◽  
Kiyoaki Tsukahara ◽  
Yoshiaki Osaka ◽  
Kazuhiro Nakamura ◽  
Ray Motohashi ◽  
...  
Keyword(s):  
Neck Dissection ◽  
Thoracic Duct ◽  
Thoracoscopic Surgery ◽  
Chylous Fistula

Selective Retrograde Thoracic Duct Embolization

2018 ◽  
Author(s):  
Abdulrahman Masrani ◽  
Bulent Arslan
Keyword(s):  
Interventional Radiology ◽  
Neck Dissection ◽  
Thoracic Duct ◽  
Lymphatic Drainage ◽  
Main Duct ◽  
Potential Complication ◽  
Wound Site ◽  
Dietary Changes ◽  
Secondary Lymphedema ◽  
Chylous Fistula

Thoracic duct injury is potential complication of neck surgeries, especially surgeries that include neck dissection. It can present as a lymphatic drainage at the wound site, chylous fistula, chylothorax, chylomediastinum, chylopericardium, lymphocele, persistent lymphorrhea, or secondary lymphedema. This complication is managed with intraoperative repair of the injury if recognized, conservative measures of dietary changes and octeriotide, thoracic duct embolization by interventional radiology, or surgical re-exploration of the wound with repair of the injury. This chapter describes a technique to selectively embolize the injured lymphatic branch of the thoracic duct utilizing coils and Onyx instead of embolizing the main duct. This technique eliminates the need for nodal or pedal lymphogram and thus saves time, effort, and reduces expense.

Thoracic Duct Embolization: A New Treatment for Massive Leak After Neck Dissection

2008 ◽  
Vol 118 (4) ◽  
pp. 680-683 ◽  
Author(s):  
Neel Patel ◽  
Robert J. Lewandowski ◽  
Michiel Bove ◽  
Albert A. Nemcek ◽  
Riad Salem
Keyword(s):  
Neck Dissection ◽  
Thoracic Duct ◽  
New Treatment

Uniportal video-assisted thoracoscopic surgery right thoracic duct ligation

ASVIDE ◽  
2021 ◽  
Vol 8 ◽  
pp. 056-056
Author(s):  
Pei Fern Koh ◽  
Narasimman Sathiamurthy ◽  
Nguk Chai Diong ◽  
Benedict Dharmaraj
Keyword(s):  
Thoracic Duct ◽  
Thoracoscopic Surgery ◽  
Video Assisted ◽  
Thoracic Duct Ligation ◽  
Duct Ligation ◽  
Video Assisted Thoracoscopic Surgery

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.

Thoracic duct injury during anterior cervical discectomy: a rare complication

1998 ◽  
Vol 88 (1) ◽  
pp. 151-154 ◽  
Author(s):  
Anna Kristina E. Hart ◽  
John H. Greinwald ◽  
Christopher I. Shaffrey ◽  
Gregory N. Postma
Keyword(s):  
Thoracic Duct ◽  
Early Recognition ◽  
Rare Complication ◽  
Content Type ◽  
Cervical Discectomy ◽  
Aggressive Management ◽  
Thoracic Duct Injury ◽  
First Case ◽  
Chyle Leakage ◽  
Chylous Fistula

✓ Chylous fistula resulting from intraoperative injury to the cervical thoracic duct is well described as a complication of neck dissection. However, injury to the thoracic duct during spinal surgery is rarely reported. The authors present the first case of thoracic duct injury occurring during cervical discectomy and fusion via an anterior approach. The anomalous location of the terminal arch of the thoracic duct in this patient contributed to the complication. The morbidity of chyle leakage is minimized by its early recognition, a thorough understanding of lymphatic system anatomy, and aggressive management of the thoracic duct injury.

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