摘要
Neck and head neoplasm, such as thyroid carcinoma, often has a high rate of regional lymph nodemetastasis.L Neck dissection is a conventmnal optmn m management of head and neck neoplasm with confirmed or suspected neck lymph node metastasis. Chylothorax represents a relatively rare early post-operative complication of neck dissection） We retrospectively analyzed neck dissection associated chylothorax in patients with thyroid carcinoma in our hospital. Published reports on neck dissection associated chylothorax were also summarized to describe clinical manifestations and optimal managements. METHODS Patients with primary thyroid carcinoma, who underwent surgery were retrospectively analyzed in the database of the Second Affiliated Hospital of Zhejiang University from June 1, 2009 to June 1, 2011. Clinical data were further analyzed in detail to determine if lateral neck dissections were performed and postoperative chylothorax occurred. Postoperative chylothorax was determined through both chest imaging manifestations and pleural effusion biochemical results. RESULTS A total number of 242 patients diagnosed as thyroid carcinoma with confirmed or suspected neck lymph node metastasis underwent lateral neck dissection. Five patients accompanied with postoperative chylothorax with an incidence of 2.07%. Symptoms occurred between the second to eighth post-operative day. Detailed clinical information was listed in Table 1. One patient with synchronous chylous leak and liquid collection in the surgical area underwent thoracic duct ligation and drainage tubes re-insertion under local anesthesia in cervical region on the third post-operative day. After re-operation, she underwent conservative therapeutics and finally got cured. The other four patients were successfully managed with conservative therapeutics. All five patients did not undergo any chronic complications of chylothorax during their 12-month follow-up durations.
Neck and head neoplasm, such as thyroid carcinoma, often has a high rate of regional lymph nodemetastasis.L Neck dissection is a conventmnal optmn m management of head and neck neoplasm with confirmed or suspected neck lymph node metastasis. Chylothorax represents a relatively rare early post-operative complication of neck dissection） We retrospectively analyzed neck dissection associated chylothorax in patients with thyroid carcinoma in our hospital. Published reports on neck dissection associated chylothorax were also summarized to describe clinical manifestations and optimal managements. METHODS Patients with primary thyroid carcinoma, who underwent surgery were retrospectively analyzed in the database of the Second Affiliated Hospital of Zhejiang University from June 1, 2009 to June 1, 2011. Clinical data were further analyzed in detail to determine if lateral neck dissections were performed and postoperative chylothorax occurred. Postoperative chylothorax was determined through both chest imaging manifestations and pleural effusion biochemical results. RESULTS A total number of 242 patients diagnosed as thyroid carcinoma with confirmed or suspected neck lymph node metastasis underwent lateral neck dissection. Five patients accompanied with postoperative chylothorax with an incidence of 2.07%. Symptoms occurred between the second to eighth post-operative day. Detailed clinical information was listed in Table 1. One patient with synchronous chylous leak and liquid collection in the surgical area underwent thoracic duct ligation and drainage tubes re-insertion under local anesthesia in cervical region on the third post-operative day. After re-operation, she underwent conservative therapeutics and finally got cured. The other four patients were successfully managed with conservative therapeutics. All five patients did not undergo any chronic complications of chylothorax during their 12-month follow-up durations.
