Chylothorax in thyroid surgery: a very rare case and systematic review of the literature.

Merki, Verena Lina; Pichler, Juliane; Giger, Roland; Mantokoudis, Georgios (2016). Chylothorax in thyroid surgery: a very rare case and systematic review of the literature. Journal of Otolaryngology - Head and Neck Surgery, 45(1), p. 52. BioMed Central 10.1186/s40463-016-0166-y

[img]
Preview
Text
art_10.1186_s40463-016-0166-y.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (451kB) | Preview

BACKGROUND

Chylothorax is a very rare but major complication in thyroid surgery and should be apparent to clinicians in this field.

CASE PRESENTATION

We report a case with chylothrax after thyroid surgery in our department that drew our attention.

METHODS

Systematic review of the literature to evaluate the incidence and the contributing factors of chylothorax after thyroid surgery. Database (PubMed) and hand searches to identify patients with thyroid surgery and postoperative chylothorax. Keywords included chylothorax, thyroidectomy, thyroid surgery and complications. Two independent reviewers screened studies against inclusion and exclusion criteria. Patient characteristics, risk factors, symptoms, treatments and etiopathogenesis were investigated.

RESULTS

We identified 13 articles in the literature describing 19 patients with chylothorax after thyroidectomy and described our own case. Ninety percent of the patients underwent thyroidectomy for thyroid cancer. Sixteen patients (80 %) underwent thyroidectomy with at least a left lateral neck dissection, 2 patients (10 %) underwent thyroidectomy with sternotomy, and in the remaining 2 patients (10 %), thyroidectomy with lateral neck dissection on both sides was performed with partial sternotomy. Our calculated incidence for chylothorax with total thyroidectomy and neck dissection was 1.85 %; for a thoracic approach the calculated incidence was 7.3 %.

CONCLUSIONS

There are no reports of chylothorax after thyroidectomy without at least a left lateral neck dissection due to advanced thyroid cancer and/or sternotomy due to the thyroid size. The extension of thyroid surgery seems to be the main risk factor in developing chylothorax either through direct surgical trauma or through increased intraductal pressure after thoracic duct ligation. An early diagnosis of chylothorax may avoid severe metabolic or cardiopulmonary complications.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)

UniBE Contributor:

Merki, Verena Lina; Pichler, Juliane; Giger, Roland and Mantokoudis, Georgios

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1916-0216

Publisher:

BioMed Central

Language:

English

Submitter:

Stefan Weder

Date Deposited:

22 May 2017 16:49

Last Modified:

15 Oct 2019 14:36

Publisher DOI:

10.1186/s40463-016-0166-y

PubMed ID:

27756377

Uncontrolled Keywords:

Chyle leak; Chylothorax; Complication; Thyroidectomy

BORIS DOI:

10.7892/boris.95649

URI:

https://boris.unibe.ch/id/eprint/95649

Actions (login required)

Edit item Edit item
Provide Feedback