Fístula quilosa posoperatoria
Keywords:
fístula quilosa, neoplasias de cabeza y cuello, linfangioma quístico, anomalías linfáticas.Abstract
Introducción: La fístula quilosa posoperatoria debida a lesión iatrogénica del conducto torácico es una complicación infrecuente y grave de la cirugía de cabeza y cuello.
Objetivo: Describir las opciones de tratamiento de la fístula quilosa cervical posquirúrgica.
Caso clínico: Se presenta un paciente de 18 años de edad con diagnóstico de linfangioma quístico de la región lateral izquierda del cuello, intervenido en el Servicio de Cirugía General del Hospital "Mnazi Mmoja", de Zanzíbar, Tanzania. Durante la evolución posoperatoria se constató una fístula quilosa de bajo débito la cual resolvió mediante tratamiento médico. El enfermo egresó curado a los 28 días después de la intervención quirúrgica.
Conclusión: El tratamiento conservador es efectivo en la mayoría de las fístulas quilosas cervicales de bajo débito, mientras que en las de débito alto la cirugía ofrece una rápida resolución, aunque no existe consenso en torno al momento ideal para realizarla.
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References
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8. Hur S, Shin JH, Lee IJ, Min SK, Min SI, Ahn S, et al. Early Experience in the Management of Postoperative Lymphatic Leakage Using Lipiodol Lymphangiography and Adjunctive Glue Embolization. J Vasc Interv Radiol. 2016 Aug [acceso: 24/02/2019];27(8):1177-86. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S1051044316301488.pdf?locale=es_ES
9. Hayashibara N, Ogawa T, Tsuji E, Ishizuna K. Efficacy of octreotide against chylothorax following lateral neck dissection for thyroid cancer: a case report. Int J Surg. 2016[acceso: 24/02/2019];21: 107-10. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4802334/pdf/main.pdf
10. Tabata H, Ojima T, Nakamori M, Nakamura M, Katsuda M, Hayata K, Matsumura S, et al. Successful treatment of chylothorax after esophagectomy using octreotide and etilefrine. Esophagus. 2016[acceso: 24/02/2019]; 13(3):306-10. Disponible en: Disponible en: https://link.springer.com/content/pdf/10.1007%2Fs10388-016-0526-8.pdf
2. Delaney S, Shi H, Shokrani A, Sinha U. Management of chyle leak after head and neck surgery: review of current treatment strategies. Int J Otolaryngol. 2017[acceso: 24/02/2019];2017:1-12. Disponible en: http://downloads.hindawi.com/journals/ijoto/2017/8362874.pdf
3. Tenny BC, Madjarov J, Shipe T . Surgical intervention in a complicated persistent chyle leak. Int J Surg Case Rep. 2018[acceso: 24/02/2019];42:7-9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5726757/pdf/main.pdf
4. Ríos A, Rodríguez JM, Torregrosa NM, Hernández AM, Parrilla P. Fístula quilosa como complicación de la cirugía tiroidea en patología maligna. Endocrinología, Diabetes y Nutrición. 2018[acceso: 24/02/2019]; 66(4):247-53. Disponible en: https://doi.org/10.1016/j.endinu.2018.07.006
5. Liu CY, Hsu PK, Huang CS, Sun YH, Wu YC, Hsu WH. Chylothorax complicating video-assisted thoracoscopic surgery for non-small cell lung cancer. World J Surg. 2014[acceso: 24/02/2019]; 38(11):2875-81. Disponible en: https://link.springer.com/content/pdf/10.1007%2Fs00268-014-2699-4.pdf
6. Lee EW, Shin JH, Ko HK, Park J, Kim SH, Sung KB. Lymphangiography to treat postoperative lymphatic leakage: a technical review. Korean J Radiol. 2014[acceso: 24/02/2019]; 15(6):724-32. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4248627/pdf/kjr-15-724.pdf
7. Moro K, Koyama Y, Kosugi Si, Ishikawa T, Ichikawa H, Hanyu T, et al. Low fat-containing elemental formula is effective for postoperative recovery and potentially useful for preventing chyle leak during postoperative early enteral nutrition after esophagectomy. Clin Nutr. 2016[acceso: 24/02/2019]; 35(6):1423-8. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S0261561416300061.pdf?locale=es_ES
8. Hur S, Shin JH, Lee IJ, Min SK, Min SI, Ahn S, et al. Early Experience in the Management of Postoperative Lymphatic Leakage Using Lipiodol Lymphangiography and Adjunctive Glue Embolization. J Vasc Interv Radiol. 2016 Aug [acceso: 24/02/2019];27(8):1177-86. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S1051044316301488.pdf?locale=es_ES
9. Hayashibara N, Ogawa T, Tsuji E, Ishizuna K. Efficacy of octreotide against chylothorax following lateral neck dissection for thyroid cancer: a case report. Int J Surg. 2016[acceso: 24/02/2019];21: 107-10. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4802334/pdf/main.pdf
10. Tabata H, Ojima T, Nakamori M, Nakamura M, Katsuda M, Hayata K, Matsumura S, et al. Successful treatment of chylothorax after esophagectomy using octreotide and etilefrine. Esophagus. 2016[acceso: 24/02/2019]; 13(3):306-10. Disponible en: Disponible en: https://link.springer.com/content/pdf/10.1007%2Fs10388-016-0526-8.pdf
Published
2020-04-14
How to Cite
1.
Nazario Dolz AM, Castillo Toledo L, Rodríguez Fernández Z. Fístula quilosa posoperatoria. Rev Cubana Med Milit [Internet]. 2020 Apr. 14 [cited 2025 Jan. 8];49(2):311-7. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/381
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