title: Prospective randomized trial of high versus low negative pressure suction in management of chyle fistula after neck dissection for metastatic thyroid carcinoma.
abstract: BACKGROUND
  Negative pressure drainage has been shown to be an effective treatment of chyle fistula. However, the optimal level of negative pressure has not been determined. We therefore conducted a prospective randomized trial to address this issue.
  
  
  METHODS
  In all, 21 patients with chyle fistula were randomly assigned to a high negative pressure suction (HNPS) group (-600 mmHg, n = 10) or low negative pressure suction (LNPS) group (-125 mmHg, n = 11). The duration of drain leakage and hospital stay, and the incidence of complications were compared between the 2 groups.
  
  
  RESULTS
  All patients were successfully treated with conservative management without surgical intervention. The median durations of chyle leakage and hospital stay were significantly shorter in the HNPS group compared with the LNPS group: 4 versus 7 days (p = .0048) and 5 versus 11 days (p = .0107), respectively.
  
  
  CONCLUSIONS
  Negative suction was demonstrated to be highly effective in the management of chyle fistula, and HNPS appeared to be more efficient than LNPS.
authors.affiliation: Department of Thyroid Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Gaosong
authors.initials: G
authors.lastname: Wu
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Chang
authors.forename: Yun
authors.initials: Y
authors.lastname: Xia
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.forename: Wayne M
authors.initials: WM
authors.lastname: Koch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000601:surgery*; D002913:Chyle / Q000378:metabolism; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects*; D011183:Postoperative Complications / Q000628:therapy; D011446:Prospective Studies; D013396:Suction / Q000379:methods*; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D055815:Young Adult