Abstract
The purpose of this study was to assess the usefulness of a sealing technique for the thoracic duct using an ultrasonically activated device during neck dissection.
We evaluated the frequency of postoperative chylous leakage retrospectively, in 43 cases (56 sides) of the FOCUS group which were treated with the sealing technique for the thoracic duct using HARMONIC FOCUS® (Johnson and Johnson) and 196 cases (232 sides) of the Ligation group which were treated with conventional ligation techniques.
Postoperative chylous leakages occurred in 4 cases (1.7%) in the Ligation group. Three of these cases improved through conservative therapy, but one required re-operation (0.4%). Meanwhile, one patient had postoperative chylous leakage in the FOCUS group (1.8%), and was treated with only conservative therapy. The frequency of chylous leakage was not statistically significantly different between the two groups (Fisher's exact test: p=1.0). The cause of chylous leakage in the FOCUS group is considered to be inadequate tissue tension in the sealing process.
We conclude that the sealing technique using HARMONIC FOCUS® is useful for safe management of the thoracic duct during neck dissection.
