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Persistent chyle leak following radical neck dissection: a solution that can be the solution
John C Muthusami1, John P Raj, D Gladwin
1Christian Medical College Hospital, Vellore, Tamilnadu, India. sur1@cmcvellore.ac.in
Annals of the Royal College of Surgeons of England
|September 24, 2005
Summary
A persistent chyle leak after neck surgery for nasopharyngeal carcinoma was successfully treated with cyanoacrylate. This case report highlights a novel approach for managing this rare complication.
Area of Science:
- Oncology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Nasopharyngeal carcinoma (NPC) often requires radical neck dissection (RND) after chemoradiation.
- Residual lymph nodal disease post-treatment poses a surgical challenge.
- Chyle leaks are a known but infrequent complication of neck dissections.
Observation:
- A patient developed a persistent chyle leak following RND for recurrent NPC.
- Conservative management failed to resolve the chyle leak.
- This necessitated an alternative therapeutic strategy.
Findings:
- The application of medical-grade cyanoacrylate effectively sealed the chyle leak.
- This represents the first documented use of cyanoacrylate for persistent chyle leak post-RND in NPC.
- Complete resolution of the chyle leak was achieved without immediate complications.
Implications:
- Cyanoacrylate offers a minimally invasive option for managing persistent chyle leaks.
- This technique may reduce the need for reoperation or prolonged hospital stays.
- Further research is warranted to establish the long-term efficacy and safety of cyanoacrylate in managing chyle leaks.