Chylous Leakage After Thyroid Cancer Surgery With Central Lymph Node Dissection:Clinical Analysis Of 14 Cases

Objective: To explore the clinical characteristics and treatment of chylous fistula effective measures of prevention and treatment of chylous leakage after central lymph node dissection(CLND).Methods: The clinical data of 14 patients who had chylous leakage after surgery of thyroid cancer and CLND were collected and analyzed,in the department of thyroid surgery,the First Hospital of China Medical University,between December 2011 and February 2017.Results: The incidence of chylous leakage was 0.5%,It occurred in the median of day was 1.5 d(range 1 to 2).The median volume of peak drainage before chylous leakage was 49 m L(range 30 to 76).When it happened,the volume increased.The median volume of the maximum drainage after surgery was 57.5 m L(range 30 to 135).Chylous fistula occurred after left CLND in 3 cases(21.4%);Right CLND in 8 cases(57.2%),in which 4 cases had r?b lymph node dissection;bilateral CLND in 3 cases(21.4%,which did not have r?b lymph node dissection).The number of lymph node is 0~14.After chylous leakage happened,2 patients were cured by low fat diet.7 cases were cured by water fasting.The remaining 5 cases had poor effect of adjusting diet.They recovered with continuous low negative pressure drainage.The median postoperative hospital stay was 5.5 days(range 4 to 14).Conclusion: Chylous leakage should be watch out when drainage increases abnormally or its character change after CLND.It can be treated by diet adjustment and continuous suction in a very short time.