title: Clinical Experience With n-Butyl-2-Cyanoacrylate in Performing Lateral Neck Dissection for Metastatic Thyroid Cancer.
abstract: Background Chyle leakage following lateral neck dissection (LND) is rare, but can induce metabolic disturbances, delay wound healing, and prolong hospitalization. n-Butyl-2-cyanoacrylate (NBCA) has been used to achieve hemostasis and seal tissues in several surgical settings. We here assessed whether application of NBCA to the thoracic duct area is effective in sealing chyle leakage. Methods The medical records of 163 patients who underwent total thyroidectomy with unilateral LND between March 2011 and September 2012 were reviewed. NBCA was applied to 84 patients and not applied to 79. Drainage volume, duration of hospital stay, and incidence of complications were compared between the 2 groups. Results The 2 groups were not different with regard to age, body weight, gender, primary tumor histology, and number of lateral neck nodes harvested. Mean hospital stay was significantly shorter (4.3 ± 1.8 vs 5.7 ± 3.0 days, P < .001), median total drainage volume was significantly smaller (270 mL; range: 97-931 mL vs 328 mL; range: 113-2636 mL; P < .001), and rate of chyle leakage was significantly lower (0% vs 6.3%, P = .025) in the NBCA than in the non-NBCA group. Conclusion NBCA application to the dissected area of the thoracic duct posterior to its angle of junction with the internal jugular and subclavian veins could be safe and effective in reducing surgical complications related to chyle leakage after LND.
authors: Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors: Hyeung Kyoo
authors: HK
authors: Kim
authors: Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors: Seok-Mo
authors: SM
authors: Kim
authors: Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors: Hojin
authors: H
authors: Chang
authors: Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors: Bup Woo
authors: BW
authors: Kim
authors: Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors: Yong Sang
authors: YS
authors: Lee
authors: National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do, Korea chiyounglim@gmail.com.
authors: Chi Young
authors: CY
authors: Lim
authors: Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors: Hang-Seok
authors: HS
authors: Chang
authors: Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors: Cheong Soo
authors: CS
authors: Park
mesh_terms: D000328:Adult; D057868:Anastomotic Leak / Q000517:prevention & control; D016208:Databases, Factual; D004659:Enbucrilate / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D061214:Patient Safety / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D014014:Tissue Adhesives / Q000494:pharmacology; D016896:Treatment Outcome
chemical_list: D014014:Tissue Adhesives; D004659:Enbucrilate
keywords: Histoacryl; chyle; lateral neck dissection; n-butyl-2-cyanoacrylate; thyroid