Your browser doesn't support javascript.
loading
Use of Octreotide for the Management of Chyle Fistula Following Neck Dissection.
Swanson, Mark S; Hudson, Rachael L; Bhandari, Nipun; Sinha, Uttam K; Maceri, Dennis R; Kokot, Niels.
Afiliação
  • Swanson MS; Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles.
  • Hudson RL; Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles.
  • Bhandari N; Keck School of Medicine, University of Southern California, Los Angeles, California.
  • Sinha UK; Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles.
  • Maceri DR; Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles.
  • Kokot N; Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles.
JAMA Otolaryngol Head Neck Surg ; 141(8): 723-7, 2015 Aug.
Article em En | MEDLINE | ID: mdl-26135979
IMPORTANCE: Chyle fistula is an uncommon complication of neck surgery. A variety of management strategies have been described, including diet restriction, parenteral nutrition, use of pressure dressings, and revision surgery. Octreotide has been used with success in patients with neck and thoracic chyle fistulas, but data regarding efficacy in neck chyle fistulas are lacking. OBJECTIVE: To evaluate the efficacy of octreotide for use in patients with postoperative chyle fistulas. DESIGN, SETTING, AND PARTICIPANTS: Retrospective review of 12 patients who received octreotide for neck chylous fistula after neck dissection was performed during the period 2004 through 2014 at 2 tertiary care academic hospitals. EXPOSURES: Patients with postoperative neck chyle fistulas were given a restricted diet and subcutaneous octreotide. MAIN OUTCOMES AND MEASURES: The main outcome was fistula closure rate, defined as fistula resolution without surgical intervention. Secondary outcomes of fistula duration (days from detection until resolution), length of hospital stay (surgery to discharge), and treatment complications were also examined. RESULTS: All 12 patients had resolution of their neck chyle fistula with octreotide therapy without need for revision surgery. Mean (SD) hospital stay was 8.7 (4.76) days, with a range of 3 to 18 days. The chyle fistula resolved after a mean (range) 5.5 (2-11) days. Self-resolving nausea was encountered in 1 patient from octreotide use, and 1 patient developed a salivary fistula as a result of the chylous fistula. CONCLUSIONS AND RELEVANCE: In these patients, octreotide was safe and effective in resolving neck chylous fistulas. Octreotide therapy appears superior to traditional conservative measures of diet restriction and pressure dressings when compared with literature rates. A prospective study is needed to confirm results, but octreotide therapy should be considered as first-line conservative management for neck chyle fistulas that occur after neck surgery.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Esvaziamento Cervical / Fármacos Gastrointestinais / Octreotida / Quilo / Fístula / Neoplasias de Cabeça e Pescoço Tipo de estudo: Etiology_studies / Observational_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: JAMA Otolaryngol Head Neck Surg Ano de publicação: 2015 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Esvaziamento Cervical / Fármacos Gastrointestinais / Octreotida / Quilo / Fístula / Neoplasias de Cabeça e Pescoço Tipo de estudo: Etiology_studies / Observational_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: JAMA Otolaryngol Head Neck Surg Ano de publicação: 2015 Tipo de documento: Article País de publicação: Estados Unidos