Chylous leakage — rare but stili dangerous complication after neck surgery
Journal Title: Otolaryngologia Polska - Year 2011, Vol 65, Issue 2
Abstract
SUMMARY latrogenic damage to the thoracic duct or large blood vessels in the neck lymph nodes, the operations carried out in the lower regions of the neck, especially the left, unfortunately, it happens even in experienced hands, because their intersection is often required for resection. It is essential to early diagnosis of complications, the best time yet in operation, which will help prevent many later, an extremely serious metabolic complications associated with loss of tissue fluid, such as electrolyte imbalance, hypovolaemia, hypoalbuminemia, hypoproteinemia, hypovolaemia, lymphopenia, immunosuppression and others, leading sometimes to death. Aim: To assess the incidence of cervical lymphorrhoea in patients who have undergone neck surgery and assessment of risk factors for this complication, and a review of methods of treatment. Materials and methods: In the years 2000-2009 in the Department of Otolaryngology and Laryngological Oncology in Poznan, among 1899 pa-tients who underwent surgery on his neck were 7 cases of iatrogenic cervical lymphorrhoea, including 2 cases of chylothorax. Results: In 6 cases, intensive medical treatment during the two weeks leading to complete cure, in a case of a patient after radical removal of metastatic medullary thyroid carcinoma descending deep into the mediastinum, reope-ration, and despite aggressive drug treatment lymphorrhoea continued, there were devastating metabolic effects leading to death. Conclusion: latrogenic fistula and lymphocele is a rare, dangerous and difficult to treat and potentially fatal complication of surgery of the neck. It should be recognized as early as possible in order to implement the treatment without committing to devastating metabolic effects.
Authors and Affiliations
Katarzyna Nowak, Małgorzata Wierzbicka, Witold Szyfter
Keywords
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