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Πέμπτη 24 Ιανουαρίου 2019

MANAGEMENT OF HIGH OUTPUT CHYLE LEAK AFTER HARVESTING OF VASCULARIZED SUPRACLAVICULAR LYMPH NODES

Vascularized lymph node transfer (VLNT) is a physiologic microsurgical technique used for the treatment of lymphedema. As VLNT is becoming more common, it is essential that we are aware of all potential complications associated with VLNT and know how to avoid and manage them when they do occur. We recently encountered a complication after supraclavicular vascularized lymph node transfer (SCVLNT) that has not been previously reported. A patient developed a recalcitrant high output (>500 mL/day) chyle leak in the neck donor site after harvesting of SCVLNT. In this paper, we share our experience with massive chyle leak and review the management strategies of how to effectively avoid and treat this potentially dangerous complication. This review of a previously unreported complication of SCVLNT is timely and important as this procedure is increasingly being offered to patients, and surgeons performing these procedures should be familiarly with effectively managing this potentially dangerous complication. Disclosures: The authors have no commercial associations or financial disclosures that might pose or create a conflict of interest with information presented in this manuscript. No funding was received for the work presented in this manuscript. Corresponding Author: David W. Chang, MD, FACS, Section of Plastic & Reconstructive Surgery, The University of Chicago Medicine & Biological Sciences, 5841 S. Maryland Ave., Rm J641, MC 6035, Chicago, IL 60637, P: 773-702-6302, F: 773-702-1634, Email: dchang@surgery.bsd.uchicago.edu ©2019American Society of Plastic Surgeons

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