Management of chyle leakage after thyroidectomy, cervical lymph node dissection, in patients with thyroid cancer

Abstract

Background: The purpose of this study was to evaluate the incidence and pattern of chyle leakage after thyroidectomy and/or cervical lymph node dissection and to establish management protocols for chyle leakage.

Methods: Patients who underwent surgical management for thyroid cancer were analyzed retrospectively.

Results: For this study, 131 patients with chyle leakage were identified; the overall incidence was 0.9%. Of them, 43.7% of patients underwent central neck dissection without lateral neck dissection, and chyle leakage was easily controlled with conservative management. Patients whose chyle drainage was reduced by >50% after dietary modification had a significantly shorter hospital stay (P < .001); NPO was the most effective dietary modification.

Conclusion: The occurrence of chyle leakage after central compartment dissection even without lateral neck dissection was not rare, but was easily controlled with conservative management. Surgical management should be considered if the drainage amount does not decrease by >50% of the original amount of the day of detection after 2 days of NPO.

Keywords: chyle leakage; conservative management; dietary modification; thoracic duct ligation.