Direct repair of iatrogenic thoracic duct injury through lymphovenous anastomosis (LVA): A case report

This is a case report of a 64‐year‐old male with cancer with an unknown primary and bilateral cervical lymph node metastases. Twelve months after chemo‐, radio‐, immunotherapy, and radical neck dissection, he presented with recurrent cervical metastases. The patient underwent radical revision neck d...

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Bibliographic Details
Published in:Journal of surgical oncology 2020-02, Vol.121 (2), p.224-227
Main Authors: Rodi, Timo, Tung Nguyen, Ba, Fritsche, Elmar, Rajan, Gunesh, Scaglioni, Mario F.
Format: Article
Language:English
Subjects:
Cancer surgery
Case reports
Iatrogenesis
ICG
indocyanine green
lymph leak
Lymphatic system
Lymphoma
lymphovenous anastomosis
Metastasis
neck dissection
thoracic duct
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Summary:This is a case report of a 64‐year‐old male with cancer with an unknown primary and bilateral cervical lymph node metastases. Twelve months after chemo‐, radio‐, immunotherapy, and radical neck dissection, he presented with recurrent cervical metastases. The patient underwent radical revision neck dissection including the deep neck muscles of the cervical plexus and reconstruction with a free anterolateral thigh flap. During tumor resection, parts of the thoracic duct were removed which resulted in a large lymph leak. This was addressed by creating a lymphovenous anastomosis to a branch of the subclavian vein. The flow of lymph was reinstated, and no leak has been observed up to a recent 6‐month follow‐up.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.25802