Nazario DAM, Castillo TL, Rodríguez FZ

Language: Spanish
References: 10
Page: 311-317
PDF size: 154.90 Kb.

ABSTRACT

Introduction: Postoperative chylous fistula due to iatrogenic thoracic duct injury is an infrequent and serious complication of head and neck surgery.
Objective: To describe the treatment options of postoperative cervical chylous fistula.
Clinical case: It was presented an 18-year-old patient with diagnosis of cystic lymphangioma of the left lateral region of the neck, which was removed in the General Surgery Service of the National Hospital Mnazi Mmoja of Zanzibar, Tanzania. During the postoperative evolution, a low-output chylous fistula was found and resolved by medical treatment. The patient withdrew cured at 28 days after the surgical intervention.
Conclusion: Conservative treatment is effective in the majority of low-out put cervical chylous fistulas, while in high-debit, surgery offers a rapid resolution, although there is no consensus about the ideal time to perform it.

REFERENCES

1. Shulan L, Wang Q, Zhao W, Han L, Wang Q, Batchu N, et al. A review of the postoperative lymphatic leakage. Oncotarget. 2017[acceso: 24/02/2019]; 8(40):69062-75. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5620321/pdf/oncotarget-08-69062.pdf

2. Delaney S, Shi H, Shokrani A, Sinha U. Management of chyle leak after head and neck surgery: review of current treatment strategies. Int J Otolaryngol. 2017[acceso: 24/02/2019];2017:1-12. Disponible en: http://downloads.hindawi.com/journals/ijoto/2017/8362874.pdf

3. Tenny BC, Madjarov J, Shipe T . Surgical intervention in a complicated persistent chyle leak. Int J Surg Case Rep. 2018[acceso: 24/02/2019];42:7-9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5726757/pdf/main.pdf

4. Ríos A, Rodríguez JM, Torregrosa NM, Hernández AM, Parrilla P. Fístula quilosa como complicación de la cirugía tiroidea en patología maligna. Endocrinología, Diabetes y Nutrición. 2018[acceso: 24/02/2019]; 66(4):247-53. Disponible en: https://doi.org/10.1016/j.endinu.2018.07.006

5. Liu CY, Hsu PK, Huang CS, Sun YH, Wu YC, Hsu WH. Chylothorax complicating video-assisted thoracoscopic surgery for non-small cell lung cancer. World J Surg. 2014[acceso: 24/02/2019]; 38(11):2875-81. Disponible en: https://link.springer.com/content/pdf/10.1007%2Fs00268-014-2699-4.pdf

6. Lee EW, Shin JH, Ko HK, Park J, Kim SH, Sung KB. Lymphangiography to treat postoperative lymphatic leakage: a technical review. Korean J Radiol. 2014[acceso: 24/02/2019]; 15(6):724-32. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4248627/pdf/kjr-15-724.pdf

7. Moro K, Koyama Y, Kosugi Si, Ishikawa T, Ichikawa H, Hanyu T, et al. Low fat-containing elemental formula is effective for postoperative recovery and potentially useful for preventing chyle leak during postoperative early enteral nutrition after esophagectomy. Clin Nutr. 2016[acceso: 24/02/2019]; 35(6):1423-8. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S0261561416300061.pdf?locale=es_ES

8. Hur S, Shin JH, Lee IJ, Min SK, Min SI, Ahn S, et al. Early Experience in the Management of Postoperative Lymphatic Leakage Using Lipiodol Lymphangiography and Adjunctive Glue Embolization. J Vasc Interv Radiol. 2016 Aug [acceso: 24/02/2019];27(8):1177-86. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S1051044316301488.pdf?locale=es_ES

9. Hayashibara N, Ogawa T, Tsuji E, Ishizuna K. Efficacy of octreotide against chylothorax following lateral neck dissection for thyroid cancer: a case report. Int J Surg. 2016[acceso: 24/02/2019];21: 107-10. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4802334/pdf/main.pdf

10. Tabata H, Ojima T, Nakamori M, Nakamura M, Katsuda M, Hayata K, Matsumura S, et al. Successful treatment of chylothorax after esophagectomy using octreotide and etilefrine. Esophagus. 2016[acceso: 24/02/2019]; 13(3):306-10. Disponible en: Disponible en: https://link.springer.com/content/pdf/10.1007%2Fs10388-016-0526-8.pdf