Chylous leakage after thyroid cancer surgery with central lymph node dissection: A clinical analysis of 14 cases
10.19538/j.cjps.issn1005-2208.2019.02.16
- Author:
Ling-xiang DONG
1
;
Liang HE
1
;
Hao ZHANG
1
Author Information
1. Department of Thyroid Surgery, the First Hospital of ChinaMedical University Shenyang 110001, China
- Publication Type:Journal Article
- Keywords:
thyroid cancer;
central lymph node dissection;
chylous leakage
- From:
Chinese Journal of Practical Surgery
2019;39(02):173-177
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE: To explore the pathogeny, the clinical characteristics, diagnosis and treatment of chylous leakage after thyroid cancer surgery with central lymph node dissection(CLND). METHODS: The clinical data of 14 cases of chylous leakage after thyroid cancer surgery with CLND admitted in the Department of Thyroid Surgery, the First Hospital of China Medical University between December 2011 and February 2017 were analyzed retrospectively.RESULTS: The incidence of chylous leakage was 0.5%. It occurred in the median of postoperative 1.5 days(range 1 to 2). The median volume of peak drainage before chylous leakage was 49 mL(range 30 to 76). When it happened, the volume increased. The median volume of the maximum drainage after surgery was 57.5 m L(range 30 to 135). Chylous fistula occurred after left CLND in 3 cases(21.4%). Right CLND in 8 cases(57.2%), in which 4 cases had rⅥb lymph node dissection. Bilateral CLND in 3 cases(21.4%, which did not have rⅥb lymph node dissection). The number of dissected lymph node were 0 to 14. After chylous leakage happened, 2 cases were cured by low fat diet and 7 cases were cured by water fasting. The remaining 5 cases had poor effect of adjusting diet. They recovered with continuous low negative pressure drainage. The median healing time was 3 days(range 1 to 8). CONCLUSION: The incidence of chylous leakage after thyroid cancer surgery with CLND is low. Chylous leakage should be watch out after CLND, when drainage increases abnormally or the liquid property change. It can be treated by diet adjustment and continuous suction in a very short time.
