| Autor: |
Pines G; 37601 Department of Thoracic Surgery, Kaplan Medical Center, Rehovot, Israel.; The Hebrew University Medical School, Jerusalem, Israel., Malka Yosef L; The Hebrew University Medical School, Jerusalem, Israel.; 37601 Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel., Lazar LO; 37601 Department of Thoracic Surgery, Kaplan Medical Center, Rehovot, Israel.; The Hebrew University Medical School, Jerusalem, Israel., Bar I; 37601 Department of Thoracic Surgery, Kaplan Medical Center, Rehovot, Israel.; The Hebrew University Medical School, Jerusalem, Israel., Schindel D; The Hebrew University Medical School, Jerusalem, Israel.; 37601 Department of Otolaryngology-Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel. |
| Abstrakt: |
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. He developed high-output chyle fistula, nonresponsive to conservative treatments. Double-layered Vicryl mesh was placed between the sponge and the jugular vein to prevent vascular injury. Immediately after initiation of the VAC therapy, the output decreased, and completely stopped after 3 days. The VAC therapy was continued for additional 5 days to ensure complete seal of the fistula by granulation tissue, by which time the wound was primarily closed. VAC therapy seems to be a safe and effective treatment for high-output cervical chyle fistula following neck dissection, avoiding complex surgical interventions. Thoracic surgeons should be aware of this low-morbidity and potentially effective treatment modality for this challenging complication. |
