title: Management of chyle leak post neck dissection: a case report and literature review.
abstract: Chyle leakage post head-and-neck resection is a rare but potentially life-threatening complication. Management may be problematic and prolonged. Recently, thoracoscopic ligation of the thoracic duct has emerged as a promising technique to definitively treat this difficult problem. We present a recent case of a hemimandibulectomy, radical modified neck dissection and osseocutaneous fibular-free-flap complicated by a chyle leakage. The chyle leak was successfully treated with thoracoscopic ligation of the thoracic duct. In the light of our clinical experience and following a thorough literature review, we have proposed that complicated or high-output chyle leaks (>1000 ml day(-1)) should be treated with early thoracoscopic thoracic duct ligation.
authors.affiliation: Department of Plastic Surgery, Addenbrookes Hospital, Cambridge, UK. ailczyszyn@doctors.org.uk
authors.forename: Andrei
authors.initials: A
authors.lastname: Ilczyszyn
authors.forename: Hyder
authors.initials: H
authors.lastname: Ridha
authors.forename: Amer J
authors.initials: AJ
authors.lastname: Durrani
mesh_terms: D000369:Aged, 80 and over; D002916:Chylothorax / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008026:Ligation; D008297:Male; D008334:Mandible / Q000601:surgery; D037981:Neck Dissection; D011183:Postoperative Complications / Q000601:surgery*; D013524:Surgical Flaps; D013897:Thoracic Duct / Q000601:surgery*; D013906:Thoracoscopy