Postoperative Chyle Leak Rate Following Neck Dissection for Squamous Cell Carcinoma Versus Papillary Thyroid Cancer

Area of Science:

• Oncology
• Surgical Oncology
• Head and Neck Surgery

Background:

• Chyle leak is a known complication of neck dissections.
• Understanding risk factors and incidence is crucial for patient management.

Purpose of the Study:

• To compare the incidence and characteristics of post-operative chyle leak following lateral neck dissection for papillary thyroid carcinoma (PTC) versus squamous cell carcinoma (SCC).

Main Methods:

• Retrospective analysis of 201 patients undergoing therapeutic neck dissection (levels II-IV) for PTC or SCC between 2010-2020.
• Chyle leak cases were reviewed, and surgical factors were analyzed.
• Duration of chyle leak was assessed using Kaplan-Meier and Cox proportional hazard analyses.

Main Results:

• Overall chyle leak rate was 6.6% (12.3% in PTC, 4.3% in SCC).
• High-volume chyle leaks and those requiring operative intervention occurred exclusively in PTC patients.
• Median chyle leak duration was longer in PTC (20.5 days) compared to SCC (12.1 days), though not statistically significant.

Conclusions:

• While overall chyle leak rates may not differ significantly between PTC and SCC on multivariable analysis, high-volume and severe leaks requiring intervention are significantly associated with PTC.
• These findings highlight the need for heightened vigilance for severe chyle leaks in patients undergoing neck dissection for PTC.