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

Abstract

Objectives: Evaluating the effectiveness of some methods of treating chylous fistula in patients with total thyroidectomy and cervical lymph node dissection for thyroid cancer treatment. Patients and method: A prospective cross-sectional descriptive study on 52 patients diagnosed with chyle leak during or after total thyroidectomy with cervical lymph node dissection for thyroid cancer treatment at the National Hospital of Endocrinology from March 2021 to March 2022. Result: Intraoperative fistula closure is 70% successful. The rate of right-sided fistula detected intraoperatively is 30%. Treatment of chylous fistula after surgery with conservative method was successful 89%, surgery 11%. Surgery to close the fistula after surgery was successful in 80%, there were no cases requiring a second surgery. The average number of days for fistula treatment was 9 ± 5 days (3-23 days) for the conservative treatment group and 9.8 ± 2.9 days (6-13 days) for the reoperative group. The postoperative time to close the fistula was 8.4 ± 3.2 days (5-13 days). Ultrasound 3 months after surgery did not detect abnormal fluid masses in the neck. The incision feeling is normal after 3 months (96.2%), the incision is soft (100%). Conclusion: Chylous fistula is a possible complication in patients undergoing thyroid surgery with cervical lymph node dissection. Cases detected during surgery are indicated for stitches. With postoperative fistula, medical treatment is indicated first, surgical treatment is considered when medical methods fail or persist.