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Endocrine

pp 1–5 | Cite as

Finger-pressing: a simple and efficient way to stop chyle leak post neck dissection

  • Dapeng Xiang
  • Zhenjie Liu
  • Tianyao Yang
  • Binglong Bai
  • Jingying Zhang
  • Chengchen Wang
  • Mao Ye
  • Zhiyu LiEmail author
Original Article
  • 21 Downloads

Abstract

Purpose

Postoperative chyle leak (CL) is a rare but severe complication after neck dissection. Conservative first-line treatments, such as total parenteral nutrition (TPN), octreotide and pressure dressing, can significantly prolong the hospital stay. Efficient and well-tolerated conservative treatment options are still lacking.

Methods

We have developed a new maneuver to treat CL called “finger-pressing.” A thumb is pressed against the point of leakage between the two muscle heads of the sternocleidomastoid. Finger-pressing continues for about 24 h until CL stops. We used this maneuver to treat six CL patients. Drainage output and duration of hospital stay were compared with another six CL patients treated using the traditional pressure dressing.

Results

The finger-pressing maneuver cured all six CL patients. Most CLs (5/6) could be controlled after about 24 h pressing. Only one high-output CL required 72 h of finger-pressing to stop the leak. All patients had their drainage tubes removed within 3 days after pressing started and all patients tolerated the treatment well. In the control group, the traditional pressure dressing time varied from 2 to 5 days, until the patient was no longer able to cooperate. Three patients underwent a second operation that cured the CL in two cases. The average hospital stay was significantly longer than that in the finger-pressing group (20 vs 9 days, p = 0.037).

Conclusions

Finger-pressing is an efficient and well-tolerated method for treating CL post neck dissection. This maneuver could be a useful adjuvant therapy to traditional methods in treating CL.

Keywords

Finger-pressing Chyle leak Neck dissection Supraclavicular fossa 

Abbreviations

CL

chyle leak

TPN

total parenteral nutrition

Notes

Acknowledgements

This study was supported by Grants 2016C33141 and 2017 C33052 from the Science and Technology Department of Zhejiang Province.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Dapeng Xiang
    • 1
  • Zhenjie Liu
    • 2
  • Tianyao Yang
    • 3
  • Binglong Bai
    • 1
  • Jingying Zhang
    • 1
  • Chengchen Wang
    • 1
  • Mao Ye
    • 1
  • Zhiyu Li
    • 1
    Email author
  1. 1.Department of General Surgery, Second Affiliated Hospital School of MedicineZhejiang UniversityHangzhouChina
  2. 2.Department of Vascular Surgery, Second Affiliated Hospital School of MedicineZhejiang UniversityHangzhouChina
  3. 3.Department of General Surgery, The Second Affiliated Hospital of Zhejiang University School of MedicineZhejiang Tiantai People’s HospitalTaizhouChina

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