Otorhinolaryngology Department, Basurto Hospital, School of Medicine, University of the Basque Country, Bilbao, Spain.
Eur J Cancer Care (Engl). 2010 Jul;19(4):510-5. doi: 10.1111/j.1365-2354.2009.01086.x. Epub 2009 Dec 17.
Chylous fistula is a serious complication of neck surgery. The aim of this study was to analyse the incidence, treatment and evolution of chylous fistula in neck dissection. We conducted a retrospective study of 304 patients, 295 (97.03%) men and nine (2.97%) women. Ages ranged from 24 to 80 years (mean = 59.28 years, SD = 6.02) and they had all undergone neck dissection. Chylous fistula occurred in four cases (1.31%). Incidence was 1.83% in laryngeal cancer and 2.7% in oral cavity and oropharyngeal cancer. No statistically significant correlation was found between tumoral stage and fistula occurrence. Radiotherapy prior to surgery was a risk factor although the association was not statistically significant. The incidence rates for radical and functional neck dissection were 3.3% and 0.46%, respectively, statistically significant (P = 0.042). The fistulas were located on the left side in all cases. One of the four patients required surgical intervention and another one died. The occurrence of chylous fistula increased significantly the length of hospital stay (P = 0.01). Chylous fistulas appear on the left side, radiotherapy prior to surgery is a risk factor and there is not correlation with tumoral stage. Chylous fistulas are significantly more common in radical than in functional dissections and increase significantly the length of hospital stay.
乳糜瘘是颈部手术后的一种严重并发症。本研究旨在分析颈清扫术中乳糜瘘的发生率、治疗方法和转归。我们对 304 例患者进行了回顾性研究，其中 295 例（97.03%）为男性，9 例（2.97%）为女性。年龄为 24 至 80 岁（平均=59.28 岁，标准差=6.02），均行颈清扫术。4 例（1.31%）发生乳糜瘘。喉癌的发生率为 1.83%，口腔癌和口咽癌的发生率为 2.7%。肿瘤分期与瘘管发生之间无统计学相关性。术前放疗是一个危险因素，但相关性无统计学意义。根治性和功能性颈清扫术的发生率分别为 3.3%和 0.46%，差异有统计学意义（P=0.042）。所有病例瘘管均位于左侧。4 例患者中，1 例需要手术干预，另 1 例死亡。乳糜瘘的发生显著增加了住院时间（P=0.01）。乳糜瘘多发生于左侧，术前放疗是一个危险因素，与肿瘤分期无相关性。根治性颈清扫术较功能性颈清扫术更易发生乳糜瘘，且显著增加了住院时间。
