scholarly journals Could Potential Postoperative Chylous Fistula Be Prevented in Patients Undergoing Neck Dissection by Using Fibrin Glue?

2021 ◽  
Vol 29 (1) ◽  
pp. 39-43
Author(s):  
İbrahim HİRA ◽  
Ali BAYRAM ◽  
Altan KAYA ◽  
Cemil MUTLU ◽  
İbrahim ÖZCAN
Keyword(s):  
Neck Dissection ◽  
Fibrin Glue ◽  
Chylous 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.

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

scholarly journals Tetracycline Sclerotherapy in the Management of Chyle Leak

2015 ◽  
Vol 6 (1) ◽  
pp. 14-16
Author(s):  
Madhumati Singh ◽  
S Vijayanand ◽  
B Amit ◽  
Ragesh Raman ◽  
R Narahari
Keyword(s):  
Neck Dissection ◽  
Treatment Modalities ◽  
Significant Morbidity ◽  
Chyle Leak ◽  
Chylous Fistula

ABSTRACT Chyle leak following neck dissection is a rare but recognized complication with significant morbidity. The timing, indications and treatment modalities of chylous fistula remain controversial. Sclerotherapy using tetracycline is not a much acclaimed form of treatment in the management of chylous fistula. We report a case of postoperative chylous leak successfully managed by injection of tetracycline into the supraclavicular wound bed. How to cite this article Singh M, Vijayanand S, Amit B, Raman R, Narahari R. Tetracycline Sclerotherapy in the Management of Chyle Leak. J Health Sci Res 2015;6(1):14-16.

Evolution of chylous fistula management after neck dissection

2013 ◽  
Vol 21 (2) ◽  
pp. 150-156 ◽  
Author(s):  
Corrado C. Campisi ◽  
Francesco Boccardo ◽  
Cesare Piazza ◽  
Corradino Campisi
Keyword(s):  
Neck Dissection ◽  
Chylous Fistula

Management of chyle fistulization in association with neck dissection

2000 ◽  
Vol 122 (3) ◽  
pp. 434-439 ◽  
Author(s):  
R. T. Gregor
Keyword(s):  
Neck Dissection ◽  
Personal Experience ◽  
Skin Flap ◽  
Fistula Formation ◽  
Protein Loss ◽  
Muscle Flaps ◽  
Chylous Leakage ◽  
Chylous Fistula ◽  
Lymph Duct ◽  
Skin Flap Necrosis

Chylous fistula after neck dissection is a relatively rare but potentially lethal complication. Sequelae range from severe fluid, electrolyte, and protein loss to fistula formation, skin-flap necrosis, and carotid blowout. A thorough knowledge of the anatomy is essential to avoid injury to the thoracic duct or right lymph duct. After surgery, drainage of large amounts of fluid, particularly if milky, may alert the surgeon to the danger of chylous leakage. Certain diagnosis, however, is not so easy. Once the diagnosis is made, the management has to address the immediate and late effects of the loss of chyle into an operative site. This article seeks to examine these factors through review of the literature and personal experience with the problem. Total parenteral nutrition allows for control of the fluid and protein loss while avoiding flow of chyle, and in most cases it results in resolution. In those cases that do not resolve, fibrin glue with some type of mesh and muscle flaps usually succeed in closure.

The Role of Somatostatin Treatment in the Management of Chylous Fistula after Neck Dissection

2014 ◽  
Vol 52 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Nilda Suslu ◽  
Bulent Sozeri ◽  
Ali Sefik Hosal ◽  
Metin Demircin
Keyword(s):  
Neck Dissection ◽  
Chylous Fistula
Sign in / Sign up

Export Citation Format

Share Document