Prevention and treatment of chylous fistula after central lymph node dissection of thyroid cancer

Objective: To discuss the causes and effective measures of prevention and treatment of chylous fistula after central lymph node dissection (CLND) of thyroid cancer. Methods: A total of 6 127 patients who underwent CLND of thyroid cancer in the Tianjin Medical University Cancer Institute and Hospital between July 2013 and June 2015 were analyzed; of which, 14 patients acquired the complication of postoperative chylous fistula. The following conservative treatments were initially performed: systemic therapy, local pressure bandaging, normal pressure drainage, 50% glucose injection, or pingyangmycin injection through a drainage tube. Surgical op- eration was then conducted when the efficacy of the treatment was poor. Results: After the conservative treatment of the 14 patients, the drainage volume gradually decreased in 12 patients, and surgery was performed on the remaining two patients. Conclusion: The CLND of thyroid cancer must be carefully conducted to prevent postoperative chylous fistula. An active conservative treatment must