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Sociedad Mexicana de Cirujanos Torácicos Genrales S.C.

2026, Number 1

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Rev Mex Cir Torac Gen 2026; 4 (1)

Thoracoscopic clipping of thoracic duct for postsurgical chylous fistula

Oviedo-Martínez F, Vargas-Abrego B

Language: Spanish
References: 11
Page: 15-19
PDF size: 1822.76 Kb.


ABSTRACT

Chylous fistula is a condition characterized by leakage of lymphatic fluid, usually secondary to a postoperative complication resulting from disruption of the thoracic duct. This pathology carries significant morbidity and mortality, leading to malnutrition, immunosuppression, and coagulopathy. Diagnosis is confirmed by determining triglyceride levels greater than 110 mg/dL in fluid obtained from the fistula, associated with the presence of chylomicrons. Treatment usually requires surgical intervention. We present the case of a 40-year-old female patient diagnosed with papillary thyroid carcinoma who underwent thyroidectomy and selective left level III and level VI neck dissection, complicated by chylous fistula treated with thoracoscopic clipping of the thoracic duct. The patient showed favorable clinical evolution and was discharged with improvement, continuing outpatient follow-up without complications. Chylous fistula is a postoperative complication with variable incidence, reported in 1.8% to 8.3% of thyroidectomies. After failure of conservative management, our clinical case demonstrates that thoracic duct ligation is a safe and effective surgical procedure for the treatment of thoracic duct injury.


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