Chyle Fistula after Neck Radical Dissection Using Harmonic Scalpel_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WEI Tao ¹ , ZHANG Guoyong ² , ZHANG Ming ¹ , ZHU Jingqiang ¹

1.Department of Thyriod and Breast Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;;
2.Department of General Surgery, Jingyuan Coal Industry Co., Ltd Workers Hospital, Baiyin 730900, Gansu Province, China;

Corresponding author：

Keywords：

Harmonic scalpel; Neck radical dissection; Chyle fistula

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

ObjectiveTo investigate the cause and treatment for chyle fistula after neck radical dissection using harmonic scalpel. MethodsFrom January 2005 to April 2009, 105 patients with thyroid carcinoma underwent thyroidectomy by harmonic scalpel (harmonic scalpel group) and 110 patients with thyroid carcinoma by conventional procedures (conventional group). Postoperative chyle fistula in all the cases was studied retrospectively. ResultsThe incidence of chyle fistula was 5.71% (6 of 105 patients) in the harmonic scalpel group and 0.91% (1 of 110 patients) in the conventional group. The difference was significant between two groups (P lt;0.05). ConclusionsHarmonic scalpel increases the risk of chyle fistula in neck radical dissection. The conventional procedures with exposing and preserving or ligating the thoracic duct can reduce the risk significantly.

Citation： WEI Tao ,ZHANG Guoyong,ZHANG Ming,ZHU Jingqiang. Chyle Fistula after Neck Radical Dissection Using Harmonic Scalpel. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(4): 411-413. doi: Copy

1.	唐亿华, 刘学明, 罗文政. 颈部淋巴结清扫术后乳糜瘘的预防及处理 [J]. 现代肿瘤学, 2005, 13(1): 8687.
2.	梁恩虎, 邹淑娟, 李思忠. 颈淋巴结清扫术后乳糜瘘 [J]. 耳鼻咽喉头颈外科, 1995, 2(2): 9495.
3.	房居高, 李思忠, 王超, 等. 颈淋巴结清扫手术后乳糜瘘的处理 [J]. 山东医大基础医学院学报, 2002, 16(2): 8586.
4.	吕平, 吕坤章, 王春友, 等. 颈部术后乳糜漏五例的治疗体会 [J]. 中华普通外科杂志, 2002, 17(11): 695.
5.	刘善廷, 缪海, 余树观. 颈部淋巴结清扫术后乳糜瘘38例治疗体会 [J]. 郑州大学学报(医学版), 2003, 38(6): 995996.
6.	Gregor RT. Management of chyle fistulization in association with neck dissection [J]. Otolaryngol Head Neck Surg, 2000, 122(3): 434439.
7.	Crumley RL, Smith JD. Postoperative chylous fistula prevention and management [J]. Laryngoscope, 1976, 86(6): 804813.
8.	李正江, 唐平章. 颈廓清术后乳糜瘘的治疗及预防 [J]. 中华耳鼻咽喉科杂志, 1998, 33(4): 244246.
9.	魏涛, 李志辉, 朱精强. 超声刀与传统方法在开放甲状腺手术的临床对比研究 [J]. 中国普外基础与临床杂志, 2008, 15（5）: 323326.
10.	张冬坤, 郭朱明, 张诠, 等. 超声刀在开放性甲状腺手术中的应用 [J]. 中国耳鼻咽喉头颈外科, 2006, 13(6): 361371.
11.	张彬, 安常明, 徐震纲, 等. 超声刀在甲状腺手术中的应用 [J]. 中国耳鼻咽喉头颈外科, 2006, 13(6): 365367.
12.	Shemen L. Thyroidectomy using the harmonic scalpel: analysis of 105 consecutive cases [J]. Otolaryngol Head Neck Surg, 2002, 127(4): 284288.
13.	Voutilainen PE, Haglund CH. Ultrasonically activated shears in thyroidectomies: a randomized trial [J]. Ann Surg, 2000, 231(3): 322328.
14.	杨春林, 贺业春, 徐士杰. 胸导管颈部的形态学 [J]. 哈尔滨医科大学学报, 1982, 31(3): 1013.
15.	陈日亭. 颌面颈手术解剖 [M]. 北京: 人民卫生出版社, 1995: 142.
16.	Gottlieb MI, Greenfield J. Variations in the terminal portion of the human thoracic duct [J]. AMA Arch Surg, 1956, 73(6): 955959.
17.	顾乃群, 朱培志, 赵文潭, 等. 胸导管颈段应用解剖 [J]. 中国临床解剖学杂志, 1990, 8(2): 7980.
18.	毛增荣, 司心成, 施恩娟, 等. 胸导管的形态结构 [J]. 解剖学报, 1966, 9(3): 349357.
19.	崔功浩. 胸导管颈段的应用解剖 [J]. 浙江医学, 1983, 5(4): 6163.
20.	沐旭升. 胸导管颈段的应用解剖 [J]. 福建医学院学报, 1990, 24(1): 9395.
21.	王圣应, 王震寰, 张荣新. 颈段胸导管的临床应用解剖研究 [J]. 淮海医药, 2000, 18(4): 241242.
22.	Van Pernis PA. Variations of the thoracic duct [J]. Surgery, 1949, 26(5): 806809.
23.	Spiro JD, Spiro RH, Strong EW. The management of chyle fistula [J]. Laryngoscope, 1990, 100(7): 771774.
24.	殷之平, 王弘士. 颈部乳糜瘘 [J]. 耳鼻咽喉头颈外科, 1997, 4(5): 315317.
25.	莫立根, 许坚, 李伟, 等. 颈廓清术后乳糜瘘21例分析 [J]. 广西医科大学学报, 2001, 18(6): 864865.
26.	Rollon A, Salazar C, Mayorga F, et al. Severe cervical chyle fistula after radical neck dissection [J]. Int J Oral Maxillofac Surg, 1996, 25(5): 363365.
27.	HarEl G, Lucente FE. Lymphatic drainage system after left radical neck dissection [J]. Ann Otol Rhinol Laryngol, 1994, 103(1): 4648.
28.	de Gier HH, Balm AJ, Bruning PF, et al. Systematic approach to the treatment of chylous leakage after neck dissection [J]. Head Neck, 1996, 18(4): 347351.
29.	Rodgers GK, Johnson JT, Petruzzelli GJ, et al. Lipid and volume analysis of neck drainage in patients undergoing neck dissection [J]. Am J Otolaryngol, 1992, 13(5): 306309.
30.	谢树夺, 陈文军, 秦川, 等. 内镜辅助生物胶黏合治疗颈部乳糜瘘二例 [J]. 中华普通外科杂志, 2007, 22(5): 331.

1. 唐亿华, 刘学明, 罗文政. 颈部淋巴结清扫术后乳糜瘘的预防及处理 [J]. 现代肿瘤学, 2005, 13(1): 8687.
2. 梁恩虎, 邹淑娟, 李思忠. 颈淋巴结清扫术后乳糜瘘 [J]. 耳鼻咽喉头颈外科, 1995, 2(2): 9495.
3. 房居高, 李思忠, 王超, 等. 颈淋巴结清扫手术后乳糜瘘的处理 [J]. 山东医大基础医学院学报, 2002, 16(2): 8586.
4. 吕平, 吕坤章, 王春友, 等. 颈部术后乳糜漏五例的治疗体会 [J]. 中华普通外科杂志, 2002, 17(11): 695.
5. 刘善廷, 缪海, 余树观. 颈部淋巴结清扫术后乳糜瘘38例治疗体会 [J]. 郑州大学学报(医学版), 2003, 38(6): 995996.
6. Gregor RT. Management of chyle fistulization in association with neck dissection [J]. Otolaryngol Head Neck Surg, 2000, 122(3): 434439.
7. Crumley RL, Smith JD. Postoperative chylous fistula prevention and management [J]. Laryngoscope, 1976, 86(6): 804813.
8. 李正江, 唐平章. 颈廓清术后乳糜瘘的治疗及预防 [J]. 中华耳鼻咽喉科杂志, 1998, 33(4): 244246.
9. 魏涛, 李志辉, 朱精强. 超声刀与传统方法在开放甲状腺手术的临床对比研究 [J]. 中国普外基础与临床杂志, 2008, 15（5）: 323326.
10. 张冬坤, 郭朱明, 张诠, 等. 超声刀在开放性甲状腺手术中的应用 [J]. 中国耳鼻咽喉头颈外科, 2006, 13(6): 361371.
11. 张彬, 安常明, 徐震纲, 等. 超声刀在甲状腺手术中的应用 [J]. 中国耳鼻咽喉头颈外科, 2006, 13(6): 365367.
12. Shemen L. Thyroidectomy using the harmonic scalpel: analysis of 105 consecutive cases [J]. Otolaryngol Head Neck Surg, 2002, 127(4): 284288.
13. Voutilainen PE, Haglund CH. Ultrasonically activated shears in thyroidectomies: a randomized trial [J]. Ann Surg, 2000, 231(3): 322328.
14. 杨春林, 贺业春, 徐士杰. 胸导管颈部的形态学 [J]. 哈尔滨医科大学学报, 1982, 31(3): 1013.
15. 陈日亭. 颌面颈手术解剖 [M]. 北京: 人民卫生出版社, 1995: 142.
16. Gottlieb MI, Greenfield J. Variations in the terminal portion of the human thoracic duct [J]. AMA Arch Surg, 1956, 73(6): 955959.
17. 顾乃群, 朱培志, 赵文潭, 等. 胸导管颈段应用解剖 [J]. 中国临床解剖学杂志, 1990, 8(2): 7980.
18. 毛增荣, 司心成, 施恩娟, 等. 胸导管的形态结构 [J]. 解剖学报, 1966, 9(3): 349357.
19. 崔功浩. 胸导管颈段的应用解剖 [J]. 浙江医学, 1983, 5(4): 6163.
20. 沐旭升. 胸导管颈段的应用解剖 [J]. 福建医学院学报, 1990, 24(1): 9395.
21. 王圣应, 王震寰, 张荣新. 颈段胸导管的临床应用解剖研究 [J]. 淮海医药, 2000, 18(4): 241242.
22. Van Pernis PA. Variations of the thoracic duct [J]. Surgery, 1949, 26(5): 806809.
23. Spiro JD, Spiro RH, Strong EW. The management of chyle fistula [J]. Laryngoscope, 1990, 100(7): 771774.
24. 殷之平, 王弘士. 颈部乳糜瘘 [J]. 耳鼻咽喉头颈外科, 1997, 4(5): 315317.
25. 莫立根, 许坚, 李伟, 等. 颈廓清术后乳糜瘘21例分析 [J]. 广西医科大学学报, 2001, 18(6): 864865.
26. Rollon A, Salazar C, Mayorga F, et al. Severe cervical chyle fistula after radical neck dissection [J]. Int J Oral Maxillofac Surg, 1996, 25(5): 363365.
27. HarEl G, Lucente FE. Lymphatic drainage system after left radical neck dissection [J]. Ann Otol Rhinol Laryngol, 1994, 103(1): 4648.
28. de Gier HH, Balm AJ, Bruning PF, et al. Systematic approach to the treatment of chylous leakage after neck dissection [J]. Head Neck, 1996, 18(4): 347351.
29. Rodgers GK, Johnson JT, Petruzzelli GJ, et al. Lipid and volume analysis of neck drainage in patients undergoing neck dissection [J]. Am J Otolaryngol, 1992, 13(5): 306309.
30. 谢树夺, 陈文军, 秦川, 等. 内镜辅助生物胶黏合治疗颈部乳糜瘘二例 [J]. 中华普通外科杂志, 2007, 22(5): 331.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Chyle Fistula after Neck Radical Dissection Using Harmonic Scalpel

Abstract Full text Figures/Tables Video References Cited by

Format

Content