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https://www.readbyqxmd.com/read/29227854/surgical-intervention-in-a-complicated-persistent-chyle-leak
#1
Bradley Curtis Tenny, Jeko Madjarov, Travis Shipe
INTRODUCTION: Chyle leak following cervical surgery has a reported incidence of around 2% annually, and the injury primarily favors a left sided involvement. Our patient presented with a right sided neck persistent chyle leak status post cervical neck dissection and radiation therapy. Infection complicated the patient's clinical course, and he inevitably required a right sided VATS thoracic duct ligation. PRESENTATION OF CASE: The patient was a 53-year-old African American male, with a past medical history of T1N0 right tonsil carcinoma status post chemo-radiation in 2016...
November 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29221335/chylothorax-after-mediastinal-ganglioneuroma-resection-treated-with-fibrin-sealant-patch-a-case-report
#2
Marco Chiarelli, Pietro Achilli, Angelo Guttadauro, Giuseppe Vertemati, Sabina Terragni, Matilde De Simone, Ugo Cioffi
Chylothorax is a severe condition resulting from the accumulation of chyle into the pleural space. We report the treatment of postoperative chylothorax after resection of mediastinal ganglioneuroma in a 17-year-old boy. Since conservative measures were not effective, we performed direct ligation of lymphatic vessels and pleurodesis. At subsequent surgical re-exploration for persisting chylothorax, accurate inspection of pleural cavity revealed residual chyle leakage. Fibrin sealant patches (TachoSil®) were placed over the source of leak with complete resolution of chylous effusion...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29206677/benchmarking-complications-associated-with-esophagectomy
#3
Donald E Low, Madhan Kumar Kuppusamy, Derek Alderson, Ivan Cecconello, Andrew C Chang, Gail Darling, Andrew Davies, Xavier Benoit D'Journo, Suzanne S Gisbertz, S Michael Griffin, Richard Hardwick, Arnulf Hoelscher, Wayne Hofstetter, Blair Jobe, Yuko Kitagawa, Simon Law, Christophe Mariette, Nick Maynard, Christopher R Morse, Philippe Nafteux, Manuel Pera, C S Pramesh, Sonia Puig, John V Reynolds, Wolfgang Schroeder, Mark Smithers, B P L Wijnhoven
OBJECTIVE: Utilizing a standardized dataset with specific definitions to prospectively collect international data to provide a benchmark for complications and outcomes associated with esophagectomy. SUMMARY OF BACKGROUND DATA: Outcome reporting in oncologic surgery has suffered from the lack of a standardized system for reporting operative results particularly complications. This is particularly the case for esophagectomy affecting the accuracy and relevance of international outcome assessments, clinical trial results, and quality improvement projects...
December 4, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29108520/a-proposed-classification-system-and-therapeutic-strategy-for-chyle-leak-after-laparoscopic-living-donor-nephrectomy-a-single-center-experience-and-review-of-the-literature
#4
Zi Qin Ng, Bulang He
OBJECTIVES: Chyle leak or chylous ascites remains a rare complication after laparoscopic living-donor nephrectomy. Its cause and management have not been well elucidated in the literature. Thus, the aim of this study was to review the incidence of chyle leak/chylous ascites after laparoscopic living-donor nephrectomy in our institute and in the literature to propose a classification system with its associated treatment strategy. MATERILAS AND METHODS: In this retrospective review of laparoscopic living-donor nephrectomy patients from January 2005 to April 2016, we identified patients with chyle leak/chylous ascites along with the care performed...
October 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29058363/minimally-invasive-esophagectomy-in-the-lateral-prone-position-experience-of-124-cases-in-a-single-center
#5
Shaohua Ma, Tianshen Yan, Dandan Liu, Keyi Wang, Jingdi Wang, Jintao Song, Tong Wang, Wei He, Jie Bai, Liang Jin
BACKGROUND: Minimally invasive esophagectomy was first introduced as a new technique for esophageal cancer treatment 20 years ago. Performing this procedure in the lateral-prone position is the most appropriate method. Since May 2013, our center has performed 124 esophageal cancer operations using this procedure. Herein, we share our experience. METHODS: We retrospectively reviewed 124 consecutive patients who had received minimally invasive esophagectomy in the lateral-prone position from May 2013 to June 2017...
October 23, 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/29021655/robot-assisted-retroperitoneal-lymph-node-dissection-feasibility-and-outcome-in-postchemotherapy-residual-mass-in-testicular-cancer
#6
Amitabh Singh, Smaranjit Chatterjee, Prashant Bansal, Abhishek Bansal, Sudhir Rawal
INTRODUCTION: We aimed to evaluate the surgical feasibility, complication, and oncological outcome of robot-assisted retroperitoneal lymph node dissection (RA-RPLND) in patients of testicular tumor with postchemotherapy residual retroperitoneal mass. METHODS: A total of 13 patients underwent RA-RPLND between January 2012 and September 2016 at our institute. A study was started on December 2015, so data were collected retrospectively and prospectively regarding patient demography, tumor characteristics, surgical, pathological outcome, and oncological outcome...
October 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28803998/high-serum-lactate-as-an-adjunct-in-the-early-prediction-of-anastomotic-leak-following-oesophagectomy
#7
B Ip, K T Ng, S Packer, S Paterson-Brown, G W Couper
BACKGROUND: Anastomotic leak (AL) following oesophagectomy carries a high mortality and morbidity. Early detection and intervention is required for a successful outcome. We have examined the role of a high postoperative serum lactate in predicting which patients are at risk of developing an anastomotic leak(AL). MATERIALS AND METHODS: All patients who underwent transthoracic oesophagectomy over a 3-year period were identified from a prospectively collected database...
October 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28683987/node-negative-esophageal-cancer-with-short-interval-isolated-metastasis-to-the-gallbladder-a-case-report
#8
REVIEW
Christopher M Hart, Kelly R Haisley, Christian Lanciault, James P Dolan
A 55 year old male smoker presented with clinical T3N0 esophageal adenocarcinoma of the GE junction. He completed neoadjuvant chemoradiotherapy with carboplatin/paclitaxel and 5040cGy of radiation. He had limited clinical response on restaging but no evidence of metastatic disease and completed a minimally invasive three field esophagectomy. This was complicated by a chyle leak requiring thoracic duct embolization from which he recovered well. Surgical pathology showed no apparent nodal disease or metastases but a poorly differentiated primary tumor with signet-cell features...
April 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28644219/an-uncommon-complication-of-laparoscopic-live-donor-nephrectomy
#9
Karen A Beer
Chylous ascites is an uncommon complication of laparoscopic live donor nephrectomy, occurring when milky chyle from the lymphatic system leaks into the peritoneal cavity. This can occur after trauma or be caused by obstruction of the lymphatic system. Treatment may include a fat-free diet, total parenteral nutrition, subcutaneous somatostatin, lymphangiography, and/or surgical closure of the leaking lymph vessel.
July 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28620562/delayed-chyle-leak-following-anterior-cervical-spinal-surgery-a-case-report-and-management-algorithm
#10
Kyle Mueller, Hasan R Syed, Jay W Rhee, Mani N Nair
Injury to the thoracic duct during anterior cervical spine surgery is a rare occurrence. A delayed chyle leak following an elective anterior cervical spinal surgery has not been reported in the literature. We present a report of a 59-year-old female with multiple prior neck surgeries who underwent an anterior cervical corpectomy and fusion (ACCF). The patient developed a delayed thoracic duct injury on postoperative day (POD) one, as no injury was noted intraoperatively. She was managed with conservative care involving a low-fat diet along with octreotide which led to the resolution of her symptoms...
May 9, 2017: Curēus
https://www.readbyqxmd.com/read/28499656/outcome-of-a-step-up-treatment-strategy-for-chyle-leakage-after-esophagectomy
#11
Teun J Weijs, Jelle P Ruurda, Maria E Broekhuizen, Tom C L Bracco Gartner, Richard van Hillegersberg
BACKGROUND: Thoracic chyle leakage is a major complication of esophagectomy. In this study our treatment strategy for chyle leakage was evaluated and its risk factors were identified. METHODS: According to the Esophagectomy Complications Consensus Group recommendations, chyle leakage was classified as follows: I, enteric dietary modifications; II, total parenteral nutrition (TPN); and III, interventional or surgical therapy. It was graded as A, less than 1,000 mL per day; or B, more than 1,000 mL per day...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28464570/-a-consensus-statement-on-the-diagnosis-treatment-and-prevention-of-common-complications-after-pancreatic-surgery-2017
#12
(no author information available yet)
Based on the latest update of the consensus statement by the International Study Group of Pancreatic Surgery, combined with China's actual situation, an update of the previous 2010 consensus on the Chinese experts of the prevention and treatment of common complications after pancreatic surgery was developed, with more than 20 extinguished experts to participate in, following many thorough discussions.This statement included pancreatic fistula, biliary fistula, postoperative bleeding, intraperitoneal infection and gastric emptying delay, and a new chapter of chyle leak...
May 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28393434/multivisceral-transplantation-for-abdominal-tumors-in-children-a-single-center-experience-and-review-of-the-literature
#13
Eliza Lee, Nicole Hodgkinson, Rima Fawaz, Khashayar Vakili, Heung Bae Kim
Standard management of intra-abdominal pediatric solid tumors requires complete resection. However, tumors with multiple organ and vascular involvement present a unique surgical challenge. We conducted a retrospective chart review of four patients, aged 2-14 years, undergoing MVT for intra-abdominal tumors with significant involvement of the visceral arteries and/or portomesenteric venous system at our institution. Indications for MVT included hepatocellular carcinoma, inflammatory myofibroblastic tumor, and two cases of hepatoblastoma...
August 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28385376/selective-en-masse-ligation-of-the-thoracic%C3%A2-duct-to-prevent-chyle-leak-after%C3%A2-esophagectomy
#14
COMPARATIVE STUDY
Yidan Lin, Zhihui Li, Gang Li, Xiaolong Zhang, Hanyu Deng, Xiaoyan Yang, Lunxu Liu
BACKGROUND: Postoperative chylothorax remains an important cause of reoperation and prolonged hospital stay after esophagectomy for the treatment of esophageal carcinoma. Chylothorax is potentially life threatening and difficult to manage. The benefit of routine thoracic duct ligation is controversial. A promising alternative is to identify chyle leaks at the time of esophagectomy and perform the ligation selectively. We developed a novel technique to identify chyle leak at the time of esophagectomy and compared it with routine ligation of thoracic duct...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28374646/staged-surgery-for-advanced-thyroid-cancers-safety-and-oncologic-outcomes-of-neural-monitored-surgery
#15
Behzad Salari, Rebecca J Hammon, Dipti Kamani, Gregory W Randolph
Objective Thyroidectomy with extensive multicompartment bilateral neck dissections for advanced-stage thyroid cancer may lead to increased risk of complications, including bilateral recurrent laryngeal nerve (RLN) paralysis and hypoparathyroidism. A planned staged approach derived from a detailed preoperative radiographic map is associated with a low complication profile. This study evaluates oncologic results and safety of neural monitored, staged thyroid cancer surgery for management of advanced thyroid cancer...
May 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28347925/life-threatening-presentation-of-thoracic-duct-injury-post-thyroid-surgery-a-case-report
#16
Hamzeh M Halawani, Sohail Bakkar, Sarah F Jamali, Farah Khalifeh, George Abi Saad
BACKGROUND: Injury to thoracic duct is a rare potential complication of time-honored conventional thyroidectomy. Nevertheless, it can be a cause of significant morbidity, and sometimes life-threatening. PATIENT FINDINGS: A 78-year-old female patient with a previous surgical history of thyroid lobectomy for nodular disease presented with primary hyperparathyroidism, and a nodule in the remaining thyroid lobe. The patient underwent completion thyroidectomy and parathyroidectomy...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28203252/management-of-chyle-leak-after-head-and-neck-surgery-review-of-current-treatment-strategies
#17
REVIEW
Sean W Delaney, Haoran Shi, Alireza Shokrani, Uttam K Sinha
Chyle leak formation is an uncommon but serious sequela of head and neck surgery when the thoracic duct is inadvertently injured, particularly with the resection of malignancy low in the neck. The thoracic duct is the primary structure that returns lymph and chyle from the entire left and right lower half of the body. Chyle extravasation can result in delayed wound healing, dehydration, malnutrition, electrolyte disturbances, and immunosuppression. Prompt identification and treatment of a chyle leak are essential for optimal surgical outcome...
2017: International Journal of Otolaryngology
https://www.readbyqxmd.com/read/28078465/non-inferiority-of-minimally-invasive-oesophagectomy-an-8-year-retrospective-case-series
#18
L Findlay, C Yao, D H Bennett, R Byrom, N Davies
BACKGROUND: The trend towards laparoscopic surgery seen in other specialties has not occurred at the same pace in oesophagectomy. This stems from concerns regarding compromised oncological clearance, and complications associated with gastric tube necrosis and anastomotic failure. We present our experience of minimally invasive oesophagectomy (MIO) compared to open and hybrid surgery. We aim to ascertain non-inferiority of MIO by evaluating impact on survival, oncological clearance by resection margin and lymph node harvest and post-operative complications...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/27993324/nontraumatic-chylothorax-diagnostic-algorithm-and-treatment-options
#19
REVIEW
Gregory Nadolski
Nontraumatic chylothorax is a relatively rare condition in which the intestinal lymph (chyle) leaks into the pleural cavity. Nontraumatic chylothorax is more difficult to treat than the more common traumatic chylothorax because the site of chylous leak may occur in less predictable locations. In the past, patients with nontraumatic chylothoraces were offered traditional fluoroscopically guided lymphangiography and thoracic duct embolization similar to traumatic chylothorax. However, the observation that thoracic duct embolization outcomes for nontraumatic chylothorax differed based on the imaging findings during lymphangiography has led to the development of a treatment algorithm, which incorporates noninvasive diagnostic studies, such as magnetic resonance lymphangiography...
December 2016: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/27993323/lymphangiography-for-thoracic-duct-interventions
#20
REVIEW
Michael S Stecker, Chieh-Min Fan
Lymph leaks resulting in chylous pleural effusions can be life-threatening. Minimally invasive thoracic duct embolization and disruption have been gaining acceptance as first-line treatment for these leaks. This review discusses the techniques for both pedal and intranodal lymphangiography in detail. It also discusses the use of lymphangiography as a means of targeting a retroperitoneal lymphatic to facilitate thoracic duct interventions for chyle leaks. Finally, outcomes and adverse events pertaining to these thoracic duct interventions are discussed...
December 2016: Techniques in Vascular and Interventional Radiology
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