CHẨN ĐOÁN RÒ DƯỠNG CHẤP Ở BỆNH NHÂN CẮT TOÀN BỘ TUYẾN GIÁP KÈM NẠO VÉT HẠCH CỔ ĐIỀU TRỊ UNG THƯ TUYẾN GIÁP

Abstract

Objectives: Describe the clinical and subclinical forms of chyle leak in patients with total thyroidectomy with cervical lymph node dissection for thyroid cancer treatment. Patients and method: A prospective cross-sectional descriptive study on 52 patients diagnosed with chylous fistula during or after total thyroidectomy with cervical lymph node dissection for thyroid cancer treatment at the National Hospital of Endocrinology since March/March/ 2021 – March 2022. Results: The most common age group is from 30 to 45 years old, accounting for 42.3%. The female/male ratio is 3/1. Intraoperative fistula has a transparent color, accounting for 100%. Postoperative fistula with milky white color is 68.9%. Time to detect fistula is the first postoperative day, accounting for 64.4%. The highest number of 24-hour drainage fluid is 80.8 ± 76.1ml (30-300ml). The concentration of Triglyceride in the fluid detected intraoperatively was 83 ± 28.9 mg/dL, no patient had a higher concentration in the fasting serum. Triglyceride concentration of post-operative fistula was 545.8 ± 489.7mg/dL. Conclusion: Chyle leak is a possible complication in patients with total thyroidectomy with cervical lymph node dissection. This complication can be detected during or after surgery. Diagnosis is based on colour, quantity, and concentration of triglycerides in the fistula fluid.