Abstract
Thoracic duct injury can cause chylous fistula. The prevalence of chylous fistula after neck surgery is reported to be 1.0 to 2.5%. Since only a few studies have been reported in our country, the details of this condition remain uncertain. Three hundred and eighty patients undergoing surgery for thyroid cancer and cervical lymphadenectomy were studied. Postoperative chylous fistula occurred in 5 (1.6%) out of 314 patients who underwent thyroid surgery with lymph node dissection, and 2 (3%) out of 66 patients who underwent cervical lymphadenectomy. In all cases, lymph node dissections were performed on the left side of the neck. Two patients needed thoracic drainage for chylothorax. In a mild case, the thoracic effusion disappeared after initiating a fat-restricted diet, whereas re-operations, including thoracic duct ligations, were needed in 5 cases. Recently, we treated 2 patients who were administered octreotide acetate, resulting in a complete resolution of chylothorax. We suggest that octreotide acetate administration is a safe and effective therapy for chylous fistula.
