The management of chyle fistula Conference Paper
| Authors: | Spiro, J. D.; Spiro, R. H.; Strong, E. W. |
| Title: | The management of chyle fistula |
| Conference Title: | 33rd World Congress of Surgery |
| Abstract: | Over a recent 4-year period, 823 neck dissections that included the lower jugular lymph nodes were performed. Of the 823, 14 (1.9%) patients developed chyle fistulas. Two other patients developed fistulas, one after undergoing a gastric transposition, and the other after a scalene node biopsy. All 16 patients were initially managed conservatively with closed-wound drainage and low-fat nutritional support; this was successful in only 4 patients, 3 of whom had peak 24-hour chyle drainage of less than 600 cc. The remaining 10 patients required open-wound management, which included operative ligation in 4 instances. Continued conservative treatment with an open neck wound resulted in significant additional hospitalization. Our experience indicates that closed-wound management of a chyle fistula is likely to fail when peak 24-hour fistula output exceeds 600 cc. Considering the cost and morbidity of conservative treatment, early reoperation may be appropriate in those patients with high fistula output. © The American Laryngological, Rhinological and Otological Society, Inc. |
| Keywords: | clinical article; neck dissection; fistula; conference paper; methodology; prospective studies; postoperative complication; lymphedema; reoperation; neck; cervical lymph node; lymphatic drainage; chyle; drainage; serum albumin; pleural effusion; chylothorax; human; priority journal; thoracic duct |
| Journal Title | Laryngoscope |
| Volume: | 100 |
| Issue: | 7 |
| Conference Dates: | 1989 Sep 10-16 |
| Conference Location: | Toronto, Canada |
| ISBN: | 0023-852X |
| Publisher: | Wiley Blackwell |
| Date Published: | 1990-07-01 |
| Start Page: | 771 |
| End Page: | 774 |
| Language: | English |
| PUBMED: | 2362537 |
| PROVIDER: | scopus |
| DOI: | 10.1288/00005537-199007000-00014 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 27 January 2020 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work