Six cases of chylous leakage after axillary lymph node dissection

Abstract

Background: Chylous leakage has been described after several surgical procedures, especially in the region of the neck and thorax. However, it has rarely been reported after axillary lymph node dissection.

Patients and methods: We encountered 6 cases of chylous leakage after axillary lymph node dissection out of a total of 882 breast cancer patients between July 2005 and June 2007 in Shandong Provincial Hospital. These 6 cases were confirmed by axillary white fluid and chylomicron interpretation. The patients were treated conservatively, including a low fat diet, compression bandage, and suction drainage.

Results: All 6 cases were successfully treated without any complications such as infection, dystrophy, and lymphoceles. The chylous leakage disappeared within a median of 5 days (range: 3-7 days). Adjuvant chemotherapy and radiotherapy were not delayed. After a median follow-up period of 12 months (range: 6-20 months), no chronic complications were observed.

Conclusion: Chylous leakage after axillary lymph node dissection is quite rare. It can be cured by conservative treatment. Lymphatic vessels should be identified carefully, and the main duct should be carefully ligated during surgical procedures, especially when level II and III lymph nodes are removed.