Abstract
Persistent chyle leakage occurring after neck dissection is a rare but potentially serious complication that can delay discharge from hospital, and may lead to fluid, electrolyte, protein, and immune disturbances. We describe a case of mandibular gingival cancer which we resected and our successful treatment of the persistent cervical chyle leakage by thoracoscopic thoracic duct ligation. An 80-year-old woman had pain in the left mandibular gingiva. Her condition was diagnosed as a squamous cell carcinoma of the left mandibular gingiva. As treatment, left mandibular resection, functional neck dissection, and immediate reconstruction by titanium plate and pectoralis major musculocutaneous flap were performed. Neck drainage increased suddenly on postoperative day 3 at 2000 ml. Conservative therapy and lymphatic ligation carried out more than twice were not effective. Therefore, we performed thoracoscopic thoracic duct ligation on postoperative day 20, which stopped the chyle leakage, making it possible to discharge the patient.
