Abstract:Objective To summarize the treatment of chylorrhea caused by cervical lymph node dissection. Methods Clinical data of 6 cases of chylorrhea diagnosed and treated from July 2021 to May 2023 were retrospectively analyzed. There were 1 case of chylorrhea after right central lymph node dissection and 5 cases of left chylorrhea after bilateral neck lymph node dissection. Among the 6 patients, 1 had intraoperative and postoperative chylorrhea, 1 had intraoperative chylorrhea, and 4 had postoperative chylorrhea. The treatment of chylous leakage during and after operation was analyzed comprehensively. Results All patients were cured after corresponding treatment. Among the 6 patients, 1 case of intraoperative chylorrhagia was treated with local ligation of the left jugular vein corner plus closure of the omohyoid muscle flap, but chylorrhagia occurred again on the 2nd day after surgery in this patient and was cured after conservative treatment including fasting, intravenous nutrition, bed rest, continuous drainage, pressure bandaging and 50% hypertonic glucose solution injection. Another patient had a large amount of chylorrhea during operation, and underwent local ligation of the left jugular vein corner and myoplasmic bioadhesive closure of the omohyoid muscle flap without postoperative chylorrhea. The other 4 patients developed chylorrhea after surgery, 3 patients were cured after conservative treatment, and the other was cured after thoracoscopic thoracic catheter ligation after conservative treatment failed. Conclusions Chylorrhea is a serious complication caused by cervical lymph node dissection. If it occurs during the operation, local ligation of the left jugular vein corner and myoplasmic closure of the omohyoid muscle flap are feasible. If it occurs after surgery, most patients can be cured after active conservative treatment, and if the conservative treatment is not effective, thoracoscopic exploration can be performed with thoracic catheter ligation.
