Chyle leakage in patients undergoing thyroidectomy plus central neck dissection for differentiated papillary thyroid carcinoma

Abstract
Background  Chyle leakage is an uncommon complication of lateral neck dissection for metastatic papillary thyroid carcinoma (PTC). There
have been no reports on chyle leakage after central neck dissection not combined with lateral neck dissection. We therefore
investigated chyle leakage in PTC patients undergoing thyroidectomy and central neck dissection.

Methods  A total of 283 new patients with differentiated PTC underwent total thyroidectomy plus central neck dissection. The amount
and duration of drain leakage, and the concentrations of triglycerides and cholesterol in drain fluid and serum were measured
in patients who had suspected postoperative chyle leakage. The incidence and management of chyle leakage were analyzed.

Results  Intraoperative chyle leakage was not found in any patient, although postoperative leakage was detected in four patients (1.4%).
Mean ± standard deviation peak 24-hour drainage was 122 ± 57 mL, and duration of leakage was 10 ± 7 days. Mean triglyceride
concentration of drainage fluid was 433 ± 182 mg/dL. These patients were treated with pressure dressings and a medium-chain
triglyceride diet. One patient underwent intralesional injection of OK-432 for localized chyle accumulation. All chyle leakages
stopped after conservative management without surgical intervention.

Conclusion  Chyle leakage can occur after thyroidectomy and central neck dissection not combined with lateral neck dissection. These findings
will aid in the recognition and treatment of this uncommon complication during the early postoperative period.

Content Type Journal ArticleCategory Head and Neck OncologyDOI 10.1245/s10434-008-0017-9Authors
Jong-Lyel Roh, Asan Medical Center, University of Ulsan College of Medicine Department of Otolaryngology 388-1, Pungnap-dong, Songpa-gu Seoul 138-736 Republic of KoreaYeo-Hoon Yoon, Chungnam National University College of Medicine Department of Otolaryngology–Head and Neck Surgery 640 Daesa-Dong, Chung-Gu Daejeon 301-040 Republic of KoreaChan Il Park, Chungnam National University College of Medicine Department of Otolaryngology–Head and Neck Surgery 640 Daesa-Dong, Chung-Gu Daejeon 301-040 Republic of Korea

Journal Annals of Surgical OncologyOnline ISSN 1534-4681Print ISSN 1068-9265 (Source: Annals of Surgical Oncology)