Nutritional Management of Thoracic Duct Fistulas. A Comparative Study of Parenteral Versus Enteral Nutrition

Abstract

Thoracic duct fistulas represent one of the serious technical complications of head and neck surgery, and reoperation for control of the leakage involves considerable morbidity and mortality. In an attempt to define the possibilities of both enteral and parenteral nutrition in the treatment of this problem, two comparable groups of patients were given, respectively, one or the other of these modalities. Significant advantages for parenteral nutrition could be demonstrated regarding duration of therapy (p < 0.05), closure rate (p < 0.05), and nutritional response (p < 0.05). These results strongly recommend the utilization of parenteral nutrition in the primary therapy of thoracic duct fistulas. (Journal of Parenteral and Enteral Nutrition 10:519-521, 1986)

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References

Hakim A. , Bernal P. , Rivera G. , et al: Surgical pathology of head and neck. IN Textbook of Surgery, Torres RR (ed). Editorial Interamericana, Mexico, 1984, p 699

Olson RM : Regional lymph node management and outcome in 100 patients with head and neck melanoma. Am J Surg 142:470. 1981

Lucente FE , Diktaban T. , Lawson W. , et al: Chyle fistula management. Otolaryngol Head Neck Surg 89:575, 1981

Gossel JD , Martin WJ , Beahrs OH , et al: Management of complicated chylous fistula following radical dissection of the neck. Surg Clin North Am 35:1091, 1955

Ramzy AI Rodriguez A. , Cowley RA : Pitfalls in the management of traumatic chylothorax. J Trauma 22:513, 1982

Selle JG , Snyder WH , Schreiber JT : Chylothorax: Indications for surgery. Ann Surg 177:245, 1973

Leeds SE , Teleszky LB , Uhley HN , et al: Thoracic duct and right lymphatic duct: Surgical approaches for drainage in the canine with comparison of cellular and chemical contents . Angiology 34:769, 1983

Kostiainen S. , Meurala H. , Mattila S. , et al: Chylothorax. Clinical experience in nine cases. Scand J Thorac Cardiovasc Surg 17:79, 1983