European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2025
Risk factors and clinical courses of chylous fistula following lateral neck dissection: a decade-long cohort study in head and neck malignancies.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zhou Yuqiu, Wang Ailian, Ma Linjie, Cai Yongcong, Zhang Xiangyu, Wang Xu, Liu Tong, Li Yongjin, Dong Shuang, Shui Chunyan, Zeng Dingfen, Zhang Sicheng, Jiang Jian, Sun Ronghao, Wang Shaoxin, Li Chao
Аннотация
INTRODUCTION: Chylous fistula (CF) is a serious complication after lateral (ND) in patients with head and neck malignancies. Due to the low incidence of this complication, its risk factors and clinical courses remain unclear. The aim of this study is to provide dependable results regarding these aspects through the largest sample size and comprehensive indicators.
METHODS: A retrospective study was conducted at our hospital from 2014 to 2024. Univariate and multivariate regression analyses were used to identify the risk factors for CF.
RESULTS: A total of 3819 consecutive neck dissections in 3733 patients were analyzed. The overall incidence of CF was 7.5 %. Logistic regression analysis revealed that alcohol use, poorly differentiated carcinoma, recurrence in lateral neck, retrieval of additional lateral lymph nodes (LNs), clinical extranodal extension (ENE) level IV and intraoperative identification of CF were independent risk factors. In subgroup analysis, alcohol use, recurrence in lateral neck, clinical ENE level IV and intraoperative identification of CF were independent risk factors for CF in papillary thyroid carcinoma, whereas retrieval of additional LNs of the lateral neck and surgical measures in the venous angle were more statistically significant in squamous cell carcinoma (SCC). The clinical courses of CF in the left neck and SCC were more severe. There were no independent risk factor for high-volume CF.
CONCLUSION: The incidence of CF after ND in head and neck malignancies was higher than expected. The risk factors for CF included variations in the lymphatic system, patient-specific clinicopathological characteristics and surgical factors.
METHODS: A retrospective study was conducted at our hospital from 2014 to 2024. Univariate and multivariate regression analyses were used to identify the risk factors for CF.
RESULTS: A total of 3819 consecutive neck dissections in 3733 patients were analyzed. The overall incidence of CF was 7.5 %. Logistic regression analysis revealed that alcohol use, poorly differentiated carcinoma, recurrence in lateral neck, retrieval of additional lateral lymph nodes (LNs), clinical extranodal extension (ENE) level IV and intraoperative identification of CF were independent risk factors. In subgroup analysis, alcohol use, recurrence in lateral neck, clinical ENE level IV and intraoperative identification of CF were independent risk factors for CF in papillary thyroid carcinoma, whereas retrieval of additional LNs of the lateral neck and surgical measures in the venous angle were more statistically significant in squamous cell carcinoma (SCC). The clinical courses of CF in the left neck and SCC were more severe. There were no independent risk factor for high-volume CF.
CONCLUSION: The incidence of CF after ND in head and neck malignancies was higher than expected. The risk factors for CF included variations in the lymphatic system, patient-specific clinicopathological characteristics and surgical factors.