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Ali Guermazi - One of the best experts on this subject based on the ideXlab platform.

  • lymphangiography in the diagnosis and localization of various Chyle leaks
    CardioVascular and Interventional Radiology, 2012
    Co-Authors: Steve Deso, Benjamin Ludwig, Niikabu Kabutey, Ducksoo Kim, Ali Guermazi
    Abstract:

    Chyle leaks are rare entities infrequently encountered by most physicians. However, large centers providing advanced surgical care are inevitably confronted with Chyle leaks as a complication of surgery, an extension of disease, or as a primary disorder. Regardless of the etiology, proper diagnosis and localization are paramount in the management of any Chyle leak. Here we present 16 patients with 17 Chyle leaks (5 chyluria, 8 chylothorax, and 4 chylous ascites) who underwent bipedal lymphangiography (LAG) and postprocedure computed tomography (CT) imaging. In each case, the source of the Chyle leak was identified and properly localized to guide further treatment. Of the 16 patients who underwent LAG and postprocedure CT imaging, the initial LAG alone provided the diagnosis and localized the Chyle leak in 4 patients (25%); the postprocedure CT imaging provided the diagnosis and localized the Chyle leak in 6 patients (37.5%); and the two modalities were equal in the diagnosing and localizing the Chyle leak in the remaining 6 patients (37.5%) These cases highlight the unparalleled abilities of LAG and the added benefit of post-LAG CT imaging in the diagnosis and fine anatomic localization of Chyle leaks. In addition, these cases demonstrate the retained utility of LAG in these investigations despite the development of alternative tests involving CT, magnetic resonance imaging, and nuclear medicine imaging.

  • lymphangiography in the diagnosis and localization of various Chyle leaks
    CardioVascular and Interventional Radiology, 2012
    Co-Authors: Steve Deso, Niikabu Kabutey, Ali Guermazi, Benjamin J Ludwig
    Abstract:

    Purpose Chyle leaks are rare entities infrequently encountered by most physicians. However, large centers providing advanced surgical care are inevitably confronted with Chyle leaks as a complication of surgery, an extension of disease, or as a primary disorder. Regardless of the etiology, proper diagnosis and localization are paramount in the management of any Chyle leak.

Tsunehiko Nishimura - One of the best experts on this subject based on the ideXlab platform.

  • the effectiveness of lymphangiography as a treatment method for various Chyle leakages
    British Journal of Radiology, 2009
    Co-Authors: Tomohiro Matsumoto, T Masunami, Rika Yoshimatsu, Takeharu Kato, Tatsuya Hirota, Takuji Yamagami, Tsunehiko Nishimura
    Abstract:

    The purpose of this study was to assess the effectiveness of lymphangiography as a treatment for various Chyle leakages. Pedal lymphangiography was performed in 9 patients (6 men and 3 women; mean age, 59 years) who were unlikely to be cured only by conservative treatment — a low-fat medium-chain triglyceride diet, total parenteral nutrition and insertion of a drainage tube — and in whom chylothorax (n = 5), chylous ascites (n = 2) and lymphatic fistulae (n = 2) were refractory to conservative treatment. In 7 of these 9 patients (78%), we could detect the Chyle leakage sites. In 8 of the 9 patients (89%), lymphatic leakage was stopped after lymphangiography, and surgical re-intervention was avoided. No cases had a recurrence of Chyle leakage during follow-up (range, 1–54 months). Lymphangiography is effective not only for diagnosis but also as treatment for various Chyle leakages. Early lymphangiography is therefore recommended for patients with Chyle leakages who are unlikely to be cured by conservative ...

  • the effectiveness of lymphangiography as a treatment method for various Chyle leakages
    British Journal of Radiology, 2009
    Co-Authors: Tomohiro Matsumoto, T Masunami, Rika Yoshimatsu, Takeharu Kato, Tatsuya Hirota, Takuji Yamagami, Tsunehiko Nishimura
    Abstract:

    The purpose of this study was to assess the effectiveness of lymphangiography as a treatment for various Chyle leakages. Pedal lymphangiography was performed in 9 patients (6 men and 3 women; mean age, 59 years) who were unlikely to be cured only by conservative treatment - a low-fat medium-chain triglyceride diet, total parenteral nutrition and insertion of a drainage tube - and in whom chylothorax (n = 5), chylous ascites (n = 2) and lymphatic fistulae (n = 2) were refractory to conservative treatment. In 7 of these 9 patients (78%), we could detect the Chyle leakage sites. In 8 of the 9 patients (89%), lymphatic leakage was stopped after lymphangiography, and surgical re-intervention was avoided. No cases had a recurrence of Chyle leakage during follow-up (range, 1-54 months). Lymphangiography is effective not only for diagnosis but also as treatment for various Chyle leakages. Early lymphangiography is therefore recommended for patients with Chyle leakages who are unlikely to be cured by conservative treatment only.

Chan Il Park - One of the best experts on this subject based on the ideXlab platform.

  • Chyle leakage in patients undergoing thyroidectomy plus central neck dissection for differentiated papillary thyroid carcinoma
    Annals of Surgical Oncology, 2008
    Co-Authors: Jonglyel Roh, Yeohoon Yoon, Chan Il Park
    Abstract:

    Background Chyle leakage is an uncommon complication of lateral neck dissection for metastatic papillary thyroid carcinoma (PTC). There have been no reports on Chyle leakage after central neck dissection not combined with lateral neck dissection. We therefore investigated Chyle leakage in PTC patients undergoing thyroidectomy and central neck dissection.

  • prospective identification of Chyle leakage in patients undergoing lateral neck dissection for metastatic thyroid cancer
    Annals of Surgical Oncology, 2008
    Co-Authors: Jonglyel Roh, Donghyun Kim, Chan Il Park
    Abstract:

    Lateral neck dissection for metastatic thyroid cancer includes the lower jugular nodes, but there has been little study of Chyle leakage. We therefore prospectively examined Chyle leakage that occurred during and after lateral neck dissection in treatment of thyroid cancer. A total of 82 consecutive patients underwent 96 lateral neck dissections for metastatic differentiated thyroid cancer—42 in the right neck, 26 in the left neck, and 14 in both. All patients were monitored for intraoperative and postoperative Chyle leakage. All postoperative drainage fluid and serum were chemically analyzed for triglycerides and cholesterol for early identification of Chyle leakage. Intraoperative Chyle leakage was observed during 5 of the 96 neck dissections (5.2%), all on the left side and all controlled by suturing Chyle fistula, thus avoiding postoperative leakage. Postoperative Chyle leakage was observed in 8 of the 96 neck dissections (8.3%), 5 in the right and 3 in the left neck. The mean peak triglyceride concentration of drainage fluid was significantly higher in patients with Chyle leakage than in those without (309 vs 42 mg/dl, P < 0.001). To stop leakage, 2 patients underwent reoperations. Chyle leakage stopped within 5–62 days (mean 18 days) after surgery. Chyle leakage related to lateral neck dissection for thyroid cancer is uncommon but may occur more frequently than reported previously, even in the right neck. Our findings may guide thyroid surgeons in both careful neck dissection in at-risk areas and proper postoperative management.

Steve Deso - One of the best experts on this subject based on the ideXlab platform.

  • lymphangiography in the diagnosis and localization of various Chyle leaks
    CardioVascular and Interventional Radiology, 2012
    Co-Authors: Steve Deso, Benjamin Ludwig, Niikabu Kabutey, Ducksoo Kim, Ali Guermazi
    Abstract:

    Chyle leaks are rare entities infrequently encountered by most physicians. However, large centers providing advanced surgical care are inevitably confronted with Chyle leaks as a complication of surgery, an extension of disease, or as a primary disorder. Regardless of the etiology, proper diagnosis and localization are paramount in the management of any Chyle leak. Here we present 16 patients with 17 Chyle leaks (5 chyluria, 8 chylothorax, and 4 chylous ascites) who underwent bipedal lymphangiography (LAG) and postprocedure computed tomography (CT) imaging. In each case, the source of the Chyle leak was identified and properly localized to guide further treatment. Of the 16 patients who underwent LAG and postprocedure CT imaging, the initial LAG alone provided the diagnosis and localized the Chyle leak in 4 patients (25%); the postprocedure CT imaging provided the diagnosis and localized the Chyle leak in 6 patients (37.5%); and the two modalities were equal in the diagnosing and localizing the Chyle leak in the remaining 6 patients (37.5%) These cases highlight the unparalleled abilities of LAG and the added benefit of post-LAG CT imaging in the diagnosis and fine anatomic localization of Chyle leaks. In addition, these cases demonstrate the retained utility of LAG in these investigations despite the development of alternative tests involving CT, magnetic resonance imaging, and nuclear medicine imaging.

  • lymphangiography in the diagnosis and localization of various Chyle leaks
    CardioVascular and Interventional Radiology, 2012
    Co-Authors: Steve Deso, Niikabu Kabutey, Ali Guermazi, Benjamin J Ludwig
    Abstract:

    Purpose Chyle leaks are rare entities infrequently encountered by most physicians. However, large centers providing advanced surgical care are inevitably confronted with Chyle leaks as a complication of surgery, an extension of disease, or as a primary disorder. Regardless of the etiology, proper diagnosis and localization are paramount in the management of any Chyle leak.

Tomohiro Matsumoto - One of the best experts on this subject based on the ideXlab platform.

  • the effectiveness of lymphangiography as a treatment method for various Chyle leakages
    British Journal of Radiology, 2009
    Co-Authors: Tomohiro Matsumoto, T Masunami, Rika Yoshimatsu, Takeharu Kato, Tatsuya Hirota, Takuji Yamagami, Tsunehiko Nishimura
    Abstract:

    The purpose of this study was to assess the effectiveness of lymphangiography as a treatment for various Chyle leakages. Pedal lymphangiography was performed in 9 patients (6 men and 3 women; mean age, 59 years) who were unlikely to be cured only by conservative treatment — a low-fat medium-chain triglyceride diet, total parenteral nutrition and insertion of a drainage tube — and in whom chylothorax (n = 5), chylous ascites (n = 2) and lymphatic fistulae (n = 2) were refractory to conservative treatment. In 7 of these 9 patients (78%), we could detect the Chyle leakage sites. In 8 of the 9 patients (89%), lymphatic leakage was stopped after lymphangiography, and surgical re-intervention was avoided. No cases had a recurrence of Chyle leakage during follow-up (range, 1–54 months). Lymphangiography is effective not only for diagnosis but also as treatment for various Chyle leakages. Early lymphangiography is therefore recommended for patients with Chyle leakages who are unlikely to be cured by conservative ...

  • the effectiveness of lymphangiography as a treatment method for various Chyle leakages
    British Journal of Radiology, 2009
    Co-Authors: Tomohiro Matsumoto, T Masunami, Rika Yoshimatsu, Takeharu Kato, Tatsuya Hirota, Takuji Yamagami, Tsunehiko Nishimura
    Abstract:

    The purpose of this study was to assess the effectiveness of lymphangiography as a treatment for various Chyle leakages. Pedal lymphangiography was performed in 9 patients (6 men and 3 women; mean age, 59 years) who were unlikely to be cured only by conservative treatment - a low-fat medium-chain triglyceride diet, total parenteral nutrition and insertion of a drainage tube - and in whom chylothorax (n = 5), chylous ascites (n = 2) and lymphatic fistulae (n = 2) were refractory to conservative treatment. In 7 of these 9 patients (78%), we could detect the Chyle leakage sites. In 8 of the 9 patients (89%), lymphatic leakage was stopped after lymphangiography, and surgical re-intervention was avoided. No cases had a recurrence of Chyle leakage during follow-up (range, 1-54 months). Lymphangiography is effective not only for diagnosis but also as treatment for various Chyle leakages. Early lymphangiography is therefore recommended for patients with Chyle leakages who are unlikely to be cured by conservative treatment only.