315 results match your criteria Chyle Fistula


Procedure-specific morbidity of pancreatoduodenectomy: a systematic review of incidence and risk factors.

ANZ J Surg 2022 06 24;92(6):1347-1355. Epub 2022 Jan 24.

Department of HPB Surgery, University Hospitals Plymouth NHS Trust, Plymouth, UK.

Background: Pancreatoduodenectomy (PD) remains the only curative-intent treatment option for patients with cancer affecting the head of the pancreas. It is high-risk and overall morbidity is around 40%. Due to the necessary resection and subsequent anastomoses required, multiple procedure-specific complications are possible. Read More

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Safety of the "incidental" neck dissection or exploration during free tissue transfer after head and neck irradiation.

Am J Otolaryngol 2022 Mar-Apr;43(2):103347. Epub 2021 Dec 24.

Department of Otolaryngology-Head and Neck Surgery, University of Missouri School of Medicine, One Hospital Drive, Columbia, MO 65212, USA. Electronic address:

Importance: Patients with either local recurrence of head and neck cancer or osteoradionecrosis after prior radiation treatment often require free tissue transfer for optimal reconstruction. In this setting, neck exploration for vessels is necessary, and an "incidental" neck dissection is often accomplished despite clinically negative cervical lymph nodes. While neck surgery in the post-radiated setting is technically challenging, the safety of post-radiated elective neck dissection or neck exploration for vessels is not well-studied, especially for patients undergoing non-laryngectomy salvage resections. Read More

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Pancreatoduodenectomy in obese patients: surgery for nonmalignant tumors might be deferred.

HPB (Oxford) 2022 Jun 3;24(6):885-892. Epub 2021 Nov 3.

Unit of General and Pancreatic Surgery, Department of Surgery and Oncology, University of Verona Hospital Trust, Verona, Italy.

Background: Obesity has traditionally been considered a cause of increased surgical complexity and poor outcomes following pancreatoduodenectomy (PD). This study aimed at evaluating the role of obesity in terms of mortality and failure to rescue (FTR), with a particular focus on nonmalignant tumors.

Methods: All patients undergoing elective PD over 10 consecutive years were analyzed. Read More

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Can Red Blood Cell Distribution Width Predict Laryngectomy Complications or Survival Outcomes?

Ann Otol Rhinol Laryngol 2021 Oct 29:34894211056117. Epub 2021 Oct 29.

Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.

Objective: Red blood cell distribution width (RDW), a reported biomarker for morbidity and mortality in chronic disease and following certain surgeries, has not been well-studied in head and neck cancer patients. The aim of the study was to examine the association of RDW with postoperative complications and survival among patients who underwent primary or salvage laryngectomy.

Methods: We analyzed a retrospective case series study of patients diagnosed with squamous cell carcinoma of the larynx treated with total laryngectomy. Read More

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October 2021

Complications After Pancreaticoduodenectomy.

Authors:
Robert Simon

Surg Clin North Am 2021 Oct 29;101(5):865-874. Epub 2021 Jul 29.

General Surgery, Department of Hepatopancreaticobiliary Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. Electronic address:

The most common complications after a pancreaticoduodenectomy are delayed gastric emptying, pancreatic fistulae, hemorrhage, chyle leaks, endocrine and exocrine pancreatic insufficiency, and surgical site infections. Understanding the potential complications and recognizing them are imperative to taking great care of these complex patients. Taking care of these patients postoperatively requires a team approach including experienced nursing staff combined with robust gastroenterology and interventional radiology. Read More

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October 2021

The efficiency of D1(+) lymphadenectomy in signet ring cell carcinoma: comparison of postoperative early and late outcomes between standard lymphadenectomy and D1(+) lymphadenectomy.

Libyan J Med 2021 Dec;16(1):1973761

Department of Surgical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey.

Signet ring cell carcinoma (SRCC) is a poorly cohesive subtype of gastric cancer. It is more aggressive than other types of gastric cancer. There is no special method for its treatment, but gastrectomy and lymphadenectomy is the standard approach. Read More

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December 2021

Video mediastinoscopy-assisted superior mediastinal dissection in the treatment of thyroid carcinoma with mediastinal lymphadenopathy: preliminary results.

BMC Surg 2021 Aug 18;21(1):329. Epub 2021 Aug 18.

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Head and Neck Surgery, Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing, China.

Background: Mediastinal lymph node metastases (MLNM) are not rare in thyroid cancer, but their treatment has not been extensively studied. This study aimed to explore the preliminary application of video mediastinoscopy-assisted superior mediastinal dissection in the diagnosis and treatment of thyroid carcinoma with mediastinal lymphadenopathy.

Materials And Methods: We retrospectively reviewed the clinical pathologic data and short-term outcomes of thyroid cancer patients with suspicious MLNM treated with video mediastinoscopy-assisted mediastinal dissection at our institution from 2017 to 2020. Read More

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Drain output volume after pancreaticoduodenectomy is a useful warning sign for postoperative complications.

BMC Surg 2021 Jun 3;21(1):279. Epub 2021 Jun 3.

Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan.

Introduction: The drain output volume (DOV) after pancreaticoduodenectomy (PD) is an easily assessable indicator in clinical settings. We explored the utility of the DOV as a possible warning sign of complications after PD.

Methods: A total of 404 patients undergoing PD were considered for inclusion. Read More

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Real-time indocyanine green lymphangiography in radical resection of right colon cancer allows the identification of chyle leakage.

Contemp Oncol (Pozn) 2021 23;25(1):64-67. Epub 2021 Feb 23.

Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Chyle leakage can be caused by abdominal surgery and managed successfully without surgical treatment; however, no preventive measures are available. Therefore, we introduce a new method to prevent post-operative chyle leakage. To investigate the role of indocyanine green (ICG) lymphangiography in the reduction of chyle fistula formation after radical resection of right colon cancer. Read More

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February 2021

Strategic Approach to Massive Chylous Leakage after Neck Dissection.

Healthcare (Basel) 2021 Mar 31;9(4). Epub 2021 Mar 31.

Department of Plastic and Reconstructive Surgery, China Medical University Hospital at Taichung, Taichung 404, Taiwan.

(1) Background: A high volume of chylous leakage (>1 L/day) is a potentially lethal complication after neck dissection. However, a strategic treatment for when the leakage progresses from high to massive (>4 L/day) is lacking. (2) Methods: The PubMed database was searched for articles on neck dissection-associated chylous leakage. Read More

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Early diagnosis of chyle fistula with SD LipidoCare after neck dissection.

J Laryngol Otol 2021 Apr 31;135(4):355-358. Epub 2021 Mar 31.

Department of Otolaryngology - Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, Hwasun, South Korea.

Objective: This study aimed to analyse the results of chyle fistula testing using the SD LipidoCare system in patients who had undergone neck dissections performed in our hospital in 2019.

Method: Sixty patients who underwent neck dissections from March 2019 to November 2019 were identified based on their medical records.

Results: Post-operative chyle fistulas were observed in 3 of 60 patients (5 per cent). Read More

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Prospective randomized controlled trial of omental roll-up technique on pancreatojejunostomy anastomosis for reducing perioperative complication in patients undergoing pancreatoduodenectomy.

J Hepatobiliary Pancreat Sci 2021 May 4;28(5):450-456. Epub 2021 May 4.

Hepato-Pancreato-Biliary Division, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Background: Wrapping pancreatojejunal anastomosis with omentum to prevent postoperative pancreatic fistula (POPF) has only been reported in non-randomized, controlled trials. Therefore, this study aimed to conduct a randomized, controlled trial to compare outcomes between omental roll-up and non-omental roll-up in pancreatojejunal anastomosis.

Methods: This single-center, randomized, two-arm trail (Clinical Trials Register: NCT03083938) was conducted between February 2017 and February 2019. Read More

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Management of chyle leaks following esophageal resection: a systematic review.

Dis Esophagus 2021 Nov;34(11)

National Oesophageal and Gastric Centre, St James's Hospital, Dublin, Ireland.

Background: Chyle leakage is an uncommon but potentially life-threatening complication following esophageal resections. The optimal management strategy is not clear, with a limited evidence base.

Methods: Searches were conducted up to 31 December 2020 on MEDLINE, Embase, and Web of Science for randomized trials or retrospective studies that evaluated the management of chyle leakage following esophageal resection. Read More

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November 2021

Chylothorax post transaxillary first rib resection for thoracic outlet syndrome.

BMJ Case Rep 2021 Mar 8;14(3). Epub 2021 Mar 8.

Department of Vascular Surgery, University of Toronto, Toronto, Ontario, Canada

We present a patient who developed high output chyle leak post left transaxillary first rib resection for venous thoracic outlet syndrome. The high output chylorrhoea was successfully treated by conservative measures, bed rest, parenteral nutrition and low-fat diet. The patient was discharged after an 18-day hospital stay with a complete resolution of his chylous fistula prior to discharge. Read More

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Post-oesophagectomy chyle leak presenting as a pleuro-enteral lymphatic shunt via the gastric conduit.

ANZ J Surg 2021 10 2;91(10):E652-E653. Epub 2021 Mar 2.

Department of Surgery, Monash University, Melbourne, Victoria, Australia.

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October 2021

A comparative study of postoperative outcomes after stapled versus handsewn gastrojejunal anastomosis for pylorus-resecting pancreaticoduodenectomy.

Ann Hepatobiliary Pancreat Surg 2021 Feb;25(1):84-89

Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun, Korea.

Backgrounds/aims: A stapler is widely used in various surgeries, and there have been recent attempts to use it for performing duodenojejunostomy and gastrojejunostomy during pancreaticoduodenectomy. This study aimed to compare the postoperative results of handsewn gastrojejunostomy (HGJ) and stapled gastrojejunstomy (SGJ) limited to pylorus-resecting pancreaticoduodenectomy (PrPD) performed by a single surgeon.

Methods: This retrospective study was conducted between January 2014 and March 2020, and included 131 patients who underwent PrPD performed by a single surgeon. Read More

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February 2021

Daily Triglyceride Output Volume as an Early Predictor for Chyle Leak Following Pancreaticoduodenectomy.

In Vivo 2021 Mar-Apr;35(2):1271-1276

Division of Digestive Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.

Background/aim: Useful prophylaxes of chyle leak (CL) after pancreatic surgery have not been established. The aim of the study was to identify an early clinical predictor for CL.

Patients And Methods: Fifty-five patients who underwent subtotal stomach preserved pancreaticoduodenectomy (SSPPD) were included. Read More

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Comparison of Outcomes of Totally Laparoscopic Total Gastrectomy (Overlap Reconstruction) versus Laparoscopic-Assisted Total Gastrectomy for Advanced Siewert III Esophagogastric Junction Cancer and Gastric Cancer of Upper and Middle Third of Stomach: Study Protocol for a Single-Center Randomized Controlled Trial.

Cancer Manag Res 2021 22;13:595-604. Epub 2021 Jan 22.

Department of Digestive Surgery, Xi Jing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China.

Background: Totally laparoscopic total gastrectomy (TLTG) using the overlap reconstruction method is associated with fewer postoperative complications and fast recovery than laparoscopic-assisted radical total gastrectomy (LATG). However, evidence on the safety and feasibility of TLTG (overlap reconstruction) in patients with advanced Siewert III esophagogastric junction cancer and gastric cancer of the upper and middle third of the stomach is scarce.

Methods: This study is a prospective, single-center, single-blind, two-arm randomized controlled trial designed to include 292 patients with advanced Siewert III esophagogastric junction cancer and gastric cancer of the upper and middle third of the stomach who will be randomly assigned to two groups: a TLTG overlap group (n=146) and an LATG group (n=146). Read More

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January 2021

Endoscopic Management of Chyluria Caused by Pyelolymphatic Fistula After Robot-Assisted Laparoscopic Pyeloplasty.

J Endourol Case Rep 2020 29;6(4):409-412. Epub 2020 Dec 29.

Department of Urology, University of Florida College of Medicine, Gainesville, Florida, USA.

Chyluria is a rare diagnosis classically associated with milky-appearing urine. It involves the leakage of chyle into the urinary tract. Although the most common cause of chyluria worldwide is infectious in nature, other noninfectious etiologies have been described. Read More

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December 2020

Prevalence of major structures injury in thyroid and neck surgeries: a national perspective.

Gland Surg 2020 Dec;9(6):1924-1932

Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.

Background: The objectives of the study is to examine the prevalence and burden of major structures injury (pharynx, esophagus, trachea, larynx, lymphatic, vessels & nerves) in patients who underwent thyroid, parathyroid, and neck dissection surgeries in the United States.

Methods: The study is a retrospective cross-sectional analysis utilizing the Nationwide Readmissions Database, 2010-2015. The study population included adults (≥18 years) patients who underwent thyroid, parathyroid, and neck dissection surgeries. Read More

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December 2020

Octreotide versus oral dietary modification for the treatment of chylous fistula following neck dissection: A systematic review and meta-analysis.

Clin Otolaryngol 2021 May 22;46(3):474-484. Epub 2021 Jan 22.

ENT Department, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.

Aims: Chylous fistula following neck surgery is a rare, but significant complication. Currently, there is no standardised treatment, which may comprise pressure dressings, oral dietary modification (ODM), surgery or a combination of such measures. Octreotide is a somatostatin analogue that has gained popularity in the management of cervical chyle leaks. Read More

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injection decreases drainage in lateral neck dissection for metastatic thyroid cancer.

Gland Surg 2020 Oct;9(5):1543-1550

Thyroid and Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, China.

Background: injection (PAI) has been proven effective against chylous fistula but not in decreasing drainage after lateral neck dissection (LND). To verify the safety of spraying PAI onto the surface of the traumatic cavity after total thyroidectomy with LND and to evaluate whether its application can reduce the drainage volume.

Methods: A total of 85 patients with metastatic papillary thyroid cancer (PTC) who agreed to total thyroidectomy with unilateral LND were recruited from March 2016 to September 2017. Read More

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October 2020

Percutaneous afferent lymphatic vessel sclerotherapy for postoperative lymphatic leakage after previous ineffective therapeutic transpedal lymphangiography.

Eur Radiol Exp 2020 11 2;4(1):60. Epub 2020 Nov 2.

Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, 69120, Heidelberg, Germany.

Background: To demonstrate the efficacy of percutaneous computed tomography (CT)-guided afferent lymphatic vessel sclerotherapy (ALVS) in the treatment of postoperative lymphatic leakage (LL) after ineffective therapeutic transpedal lymphangiography (TL).

Methods: A retrospective review in this institute involving 201 patients was conducted from May 2011 to September 2018. Patients diagnosed with postoperative LL undergoing ineffective therapeutical TL before the performance of percutaneous CT-guided ALVS were involved. Read More

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November 2020

The roles of iodized oil-based lymphangiography and post-lymphangiographic computed tomography for specific lymphatic intervention planning in patients with postoperative lymphatic fistula: a literature review and case series.

CVIR Endovasc 2020 Oct 21;3(1):79. Epub 2020 Oct 21.

Clinic for Diagnostic and Interventional Radiology, University Hospital Heidelberg, INF 110, 69120, Heidelberg, Germany.

In the management of patients with postoperative lymphatic fistula (LF) in different locations, iodized oil-based lymphangiography (LAG) from trans-pedal or intranodal route is an established diagnostic approach with the potential to plan further interventional treatments. However, specific lymphatic interventions are indicated depending on different locations and morphologies of the LF. After a systematic literature review, four types of interventions can be considered, including direct leakage embolization/sclerotherapy (DLE/DLS), percutaneous afferent lymphatic vessel embolization (ALVE), percutaneous afferent lymphatic vessels disruption/sclerotherapy (ALVD/ALVS), and trans-afferent nodal embolization (TNE). Read More

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October 2020

Robotic and open pancreaticoduodenectomy: results from Taipei Veterans General Hospital in Taiwan.

Updates Surg 2021 Jun 17;73(3):939-946. Epub 2020 Oct 17.

Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang Ming University, 201 Section 2 Shipai Road, Taipei, 112, Taiwan.

This study is to clarify the feasibility and justification of robotic pancreaticoduodenectomy (RPD) by comparing the outcomes between RPD and open pancreaticoduodenectomy (OPD) groups. All perioperative data and outcomes were prospectively collected. There were 304 (63. Read More

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Mesopancreas level 3 dissection in robotic pancreaticoduodenectomy.

Surgery 2021 02 4;169(2):362-368. Epub 2020 Sep 4.

Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan. Electronic address:

Background: There are no reports of performing mesopancreas dissections in robotic pancreaticoduodenectomy. This study evaluated the feasibility and justification for mesopancreas level 3 dissection in robotic pancreaticoduodenectomy.

Methods: Surgical outcomes after robotic pancreaticoduodenectomy and open pancreaticoduodenectomy were evaluated and compared. Read More

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February 2021

Negative-Pressure Vacuum Therapy for High-Output Chyle Leak Following Neck Dissection.

Innovations (Phila) 2020 Sep/Oct;15(5):481-483. Epub 2020 Jul 5.

The Hebrew University Medical School, Jerusalem, Israel.

Chyle fistula is a challenging complication following neck dissection carrying a high morbidity and mortality rate. Herein we present a challenging case of successful management of high-output left-sided cervical chyle fistula with negative-pressure vacuum (VAC) therapy in a case where all conservative treatments failed. A 40-year-old man with lymphoma and supraglottic carcinoma underwent endoscopic resection and bilateral neck dissections. Read More

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Intraoperative application of inactivated Pseudomonas aeruginosa in patients undergoing lateral neck dissection for metastatic thyroid cancer: A randomized, parallel group, placebo-controlled trial.

Surgery 2020 08 18;168(2):340-346. Epub 2020 May 18.

Thyroid Surgery Center, West China Hospital of Sichuan University, Chengdu, China.

Background: We hypothesize that the intraoperative, prophylactic application of Pseudomonas aeruginosa can decrease postoperative chylous fistula and enhance recovery after surgery in patients with thyroid cancer undergoing lateral neck lymph node dissection.

Method: In this single-center trial, we assigned randomly 200 patients with thyroid cancer who had proven lateral lymph node metastasis to groups receiving either 2 mL Pseudomonas aeruginosa spray (Pseudomonas aeruginosa group) or 2 mL saline spray (control group) in the lateral cervical surgical field. The primary end points were the rate of chylous fistula, mean difference in the duration and volume of drainage fluid, days of postoperative hospital stay, and overall cost. Read More

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False vocal cord perforation with abscess treated by negative pressure wound therapy.

SAGE Open Med Case Rep 2020 2;8:2050313X20915415. Epub 2020 Apr 2.

Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.

Perforation of the larynx is very rare but may result in severe airway complications that include pneumothorax, pneumonia, mediastinitis, and retropharyngeal abscess. If conservative treatment fails, aggressive treatments including reconstructive surgery with pedicle flap are considered. Negative pressure wound therapy has been used for large skin defects, necrotizing fasciitis, pharyngocutaneous fistula, stoma dehiscence, osteoradionecrosis of the mandible, chyle fistula, flap failure, and lymphangioma in the field of head and neck surgery. Read More

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Ultrasound-guided percutaneous injection of Pseudomonas aeruginosa-mannose sensitive hemagglutinin for treatment of chyle fistula following neck dissection: Two case reports.

Medicine (Baltimore) 2020 Jan;99(5):e18816

Department of Thyroid and Parathyroid Surgery Center.

Rationale: Chyle fistula is a rare but troublesome complication of neck dissection. Topical application of Pseudomonas aeruginosa-mannose sensitive hemagglutinin (PA-MSHA) injection has been reported as a novel, viable, and effective approach in the treatment of chyle fistula following neck dissection. However, there have been no reports regarding the treatment of chyle fistula using ultrasound (US)-guided percutaneous injection of PA-MSHA. Read More

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January 2020