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Date Published: 10/01/2022
Online Published: 10/01/2022
Abstract Views: 599
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DOI: https://doi.org/10.55046/vjrnm.45.58.2021
Issue
No. 45 (2021)
Section
Scientific research
How to Cite
Nguyen, N. C., Cảnh, P. H. ., Khánh Chi, T. N. ., Tính, T. Q. ., Lưu, Đoàn T. ., & Linh, L. T. . (2022). Assessing the results of thoracic duct embolization for chyle leakage after thyroidectomy in patients with thyroid cancer. Vietnamese Journal of Radiology and Nuclear Medicine, 45, 4-10. https://doi.org/10.55046/vjrnm.45.58.2021

Assessing the results of thoracic duct embolization for chyle leakage after thyroidectomy in patients with thyroid cancer

Nguyen Ngoc Cuong, Phạm Hồng Cảnh, Trần Nguyễn Khánh Chi, Triệu Quốc Tính, Đoàn Tiến Lưu, Lê Tuấn Linh

Main Article Content

Abstract

Background: chylous leakage after operation of head and neck is rare but well-known complication. Almost patients with this complication can be treated conservatively but in patients with high flow leakage, the following treatments will be very complicated.
Purpose: to report the results of percutaneous thoracic duct embolization (TDE) treatment for chylous leakage of the neck in patients post thyroidectomy and cervical lymph node dissection due to thyroid cancer.
Methods: 15 consecutive patients with high flow chylous leak post thyroidectomy were sent to our hospital after failed conservative treatment.
All patient were undergone intra nodal lymphagiography then thoracic duct embolization.
Results: Fifteen patients with cervical chylorrhea through drainage more than 300 ml/day during average 2 weeks (1 to 5 weeks) were included in this study. TDE was archived in 15/15 patients in which 14/15 TD were embolized ategrade and 1/15 TD was embolized retrograde. One patient had recurrent chylous leakage after 1 week due to recanalization of TD. She was then undergone TD sclerosis injection under CT scanner guidance. All patients had clinical successful with no chylorrhea after intervention. No major complication was noted. All patients were discharged in following weeks after intervention.
Conclusion: TDE is minimal invasive and effective treatment for cervical chylous leakage post thyroidectomy.

Article Details

Keywords

chylous leak, chylorrhea, thoracic duct embolization

References

1. Park I, Her N, Choe J-H, Kim JS, Kim J-H. Management of chyle leakage after thyroidectomy, cervical lymph node dissection, in patients with thyroid cancer. Head & Neck. 2018;40(1):7-15. doi:10.1002/hed.24852
2. Delaney SW, Shi H, Shokrani A, Sinha UK. Management of Chyle Leak after Head and Neck Surgery: Review of Current Treatment Strategies. International Journal of Otolaryngology. doi:https://doi.org/10.1155/2017/8362874
3. Itkin M, Chen E. Thoracic Duct Embolization. Semin intervent Radiol. 2011;28(02):261-266. doi:10.1055/s-0031-1280676
4. Chen E, Itkin M. Thoracic Duct Embolization for Chylous Leaks. Semin Intervent Radiol. 2011;28(1):63-74. doi:10.1055/s-0031-1273941
5. Lv S, Wang Q, Zhao W, et al. A review of the postoperative lymphatic leakage. Oncotarget. 2017;8(40):69062- 69075. doi:10.18632/oncotarget.17297
6. Cope C. Diagnosis and Treatment of Postoperative Chyle Leakage via Percutaneous Transabdominal Catheterization of the Cisterna Chyli: A Preliminary Study. Journal of Vascular and Interventional Radiology. 1998;9(5):727-734. doi:10.1016/S1051-0443(98)70382-3
7. Cope C, Kaiser LR. Management of Unremitting Chylothorax by Percutaneous Embolization and Blockage of Retroperitoneal Lymphatic Vessels in 42 Patients. Journal of Vascular and Interventional Radiology. 2002;13(11):1139-1148. doi:10.1016/S1051-0443(07)61956-3
8. Itkin M, Kucharczuk JC, Kwak A, Trerotola SO, Kaiser LR. Nonoperative thoracic duct embolization for traumatic thoracic duct leak: Experience in 109 patients. The Journal of Thoracic and Cardiovascular Surgery. 2010;139(3):584-590. doi:10.1016/j.jtcvs.2009.11.025
9. Guevara CJ, Rialon KL, Ramaswamy RS, Kim SK, Darcy MD. US–Guided, Direct Puncture Retrograde Thoracic Duct Access, Lymphangiography, and Embolization: Feasibility and Efficacy. Journal of Vascular and Interventional Radiology. 2016;27(12):1890-1896. doi:10.1016/j.jvir.2016.06.030
10. Bundy JJ, Chick JF, Jiao A, et al. Percutaneous fluoroscopically-guided transcervical retrograde access facilitates successful thoracic duct embolization after failed antegrade transabdominal access. Lymphology. 2019;52(2):52-60.
11. Tuan LL, Ngoc CN, Viet HT, Le H, Pons F, Natali D. An uncommon therapeutic option for a challenging cause of pleural effusion. Breathe. 2019;15(2):e69-e76. doi:10.1183/20734735.0014-2019
12. Bhatia SS, Karas TZ, Pereira K, King MJ, Yrizarry J. Treatment of Chyle Leak by Percutaneous Alcohol Sclerosis of the Cisterna Chyli: A Case Report. Cardiovasc Intervent Radiol. 2015;38(3):773-775. doi:10.1007/ s00270-014-0839-8
13. Steven BR, Carey S. Nutritional management in patients with chyle leakage: a systematic review. Eur J Clin Nutr. 2015;69(7):776-780. doi:10.1038/ejcn.2015.48
14. Pamarthi V, Stecker MS, Schenker MP, et al. Thoracic Duct Embolization and Disruption for Treatment of Chylous Effusions: Experience with 105 Patients. Journal of Vascular and Interventional Radiology. 2014;25(9):1398- 1404. doi:10.1016/j.jvir.2014.03.027
15. Laslett D, Trerotola SO, Itkin M. Delayed Complications following Technically Successful Thoracic Duct Embolization. Journal of Vascular and Interventional Radiology. 2012;23(1):76-79. doi:10.1016/j.jvir.2011.10.008