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Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

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Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
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Related Experiment Video

Updated: Jun 20, 2025

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
05:10

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Published on: September 15, 2023

942

Massive Chylous Leakage After Endoscopic Thyroidectomy with Central Lymph Node Dissection: A Case Report.

Tengjiang Long1, Tingjie Yin1, Zeyu Yang1

  • 1Department of Breast and Thyroid Surgery, Chongqing General Hospital, Chongqing, China.

The American Journal of Case Reports
|July 19, 2024
PubMed
Summary

Massive chylous leakage after endoscopic thyroid surgery is rare but serious. Surgical reintervention with lymphatic vessel clamping effectively managed a challenging case, offering a potential solution for this complication.

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Massive chylous leakage is a rare, life-threatening complication of neck dissection, particularly uncommon after endoscopic thyroid surgery.
  • Chylous leakage presents management challenges including prolonged hospitalization, nutritional deficits, and electrolyte imbalances.
  • Prompt recognition and management are crucial for mitigating adverse patient outcomes.

Observation:

  • A 37-year-old woman with papillary thyroid carcinoma underwent endoscopic thyroidectomy with central lymph node dissection.
  • The patient developed significant postoperative chylous leakage, refractory to conservative treatments like fasting, parenteral nutrition, and somatostatin infusion.
  • A reoperation identified the lymphatic leak, which was successfully managed by clamping the vessel with a biological clamp.

Findings:

  • Surgical reintervention with a biological clamp provided definitive treatment for refractory chylous leakage post-endoscopic thyroidectomy.
  • The patient experienced complete resolution of the chylous leak and uneventful recovery after the second procedure.
  • This case highlights the successful application of surgical intervention in managing a rare complication.

Implications:

  • This case underscores the challenges in managing chylous leakage following endoscopic thyroidectomy, where experience is limited.
  • Raising awareness of this complication and its successful surgical management is vital for improving patient care.
  • Further research into prevention and standardized treatment protocols for chylous leakage in endoscopic thyroid surgery is warranted.