Chyle Leak

cyfont

Hi. Has anyone here ever seen expereience a "Chyle Leak" after a Neck Dissection?  Had my Neck Dissection surgery on 12/10/19. I had 20 lymph nodes removed and they showEd no active cancer! I had chemo(3 cisplatin) and 35 radiation treatments on left side for Stage IV Oropharyngea, HPV 16. I've been placed on a 2 week fat-free diet to stop and repair the leak. Any info. Or experience with this would be appreciated. 

wbcgaruss

Yes I Had a Chyle Leak

On Sept 18, 2019, I was operated on for cancer of the lymph nodes a radical neck dissection at Hershey Med in PA. Things went well but the cancer was a bit more advanced than expected but they felt that they got it all. The problem I had was the one you are having as in the operation to remove cancer a valve in the lymph system called a chyle valve was damaged and it kept flowing or pushing lymph fluid right through and filling my operation drain reservoir constantly. They had me on a fat-free diet through a feeding tube in my nose as I was swelled from the operation and could not eat without aspirating. They also had a bundle of cloth bandages taped to my neck area to put pressure on the leaking area to get it to stop which had to be retaped at times which was getting hard on my skin and starting to pull some skin off. So they quit using the tape and came up with a combination of ace bandages and wrapped around my body to hold the bundle there and I would say it was shaped like a ball or oval. Anyway, the diet or this pressure held on the area to stop the chyle leak did not work.

The tube that feeds the chyle valve comes up the right side of your body from down in your abdomen and goes up to your chest then crosses over to the left side and goes up to your neck where it is now leaking.

Next, they did an operation where they looked at the tube in the area of my abdomen I think down pretty low and they said if it is pretty round they could wind a spring-like device in there to fill up the tube which would let fluid through but would slow it down considerably. Unfortunately, mine was odd-shaped and this would not work in my case. So in the same operation while I was still under they tried something else they made small holes in my arms above my elbows and put some kind of oil under pressure into my lymph system. This did not stop the chyle leak either.

Then a thoracic surgeon got involved. He is the one who told me how the tube runs through your body, up the right side of your body from down in your abdomen and goes up to your chest then crosses over to the left side and goes up to your neck where it is now leaking. He even drew a picture on the board for me to see. He told me since the spring idea could not be done because of the odd-shaped tube in that area, and the oil under pressure did not work, and the likelihood of going back into the original operation area and opening it back up and repairing the chyle valve was not likely at all as there was probably too much damage. So he said the only place that is not damaged in this feed tube and is original yet is on the right side between the abdomen and the upper chest area. He said he was going on the right side of my chest and it may have been robotic surgery because it was done through small holes or incisions. He said he was going in and bundle tissue with this tube, tie it off somehow and squeeze or pinch it off to slow down the flow to the chyle valve area which he did and thank God it was successful and it started slowing down and in a couple of days was pretty much stopped. And it did stop eventually, and completely and they could finally remove my drain reservoir. I was impressed with the thoracic surgeon, he explained things to you before and after the surgery and had a great bedside manner and treated me well. I looked him up later and found I had a top-notch surgeon in my corner as he is chief of the Division of Thoracic Surgery at Penn State Health Milton S. Hershey Medical Center, a professor of surgery at Penn State College of Medicine and the program director for the Thoracic Surgery Residency program.

I had some other complications but this was the big thing to get the chyle leak stopped. I hope your chyle leak is easier to get stopped but this gives you an idea there are other ways they can go to help you.

Sorry this is so long but I wanted to explain as best I can.

Take Care-God Bless

cyfont

wbcgaruss said:

Yes I Had a Chyle Leak

On Sept 18, 2019, I was operated on for cancer of the lymph nodes a radical neck dissection at Hershey Med in PA. Things went well but the cancer was a bit more advanced than expected but they felt that they got it all. The problem I had was the one you are having as in the operation to remove cancer a valve in the lymph system called a chyle valve was damaged and it kept flowing or pushing lymph fluid right through and filling my operation drain reservoir constantly. They had me on a fat-free diet through a feeding tube in my nose as I was swelled from the operation and could not eat without aspirating. They also had a bundle of cloth bandages taped to my neck area to put pressure on the leaking area to get it to stop which had to be retaped at times which was getting hard on my skin and starting to pull some skin off. So they quit using the tape and came up with a combination of ace bandages and wrapped around my body to hold the bundle there and I would say it was shaped like a ball or oval. Anyway, the diet or this pressure held on the area to stop the chyle leak did not work.

The tube that feeds the chyle valve comes up the right side of your body from down in your abdomen and goes up to your chest then crosses over to the left side and goes up to your neck where it is now leaking.

Next, they did an operation where they looked at the tube in the area of my abdomen I think down pretty low and they said if it is pretty round they could wind a spring-like device in there to fill up the tube which would let fluid through but would slow it down considerably. Unfortunately, mine was odd-shaped and this would not work in my case. So in the same operation while I was still under they tried something else they made small holes in my arms above my elbows and put some kind of oil under pressure into my lymph system. This did not stop the chyle leak either.

Then a thoracic surgeon got involved. He is the one who told me how the tube runs through your body, up the right side of your body from down in your abdomen and goes up to your chest then crosses over to the left side and goes up to your neck where it is now leaking. He even drew a picture on the board for me to see. He told me since the spring idea could not be done because of the odd-shaped tube in that area, and the oil under pressure did not work, and the likelihood of going back into the original operation area and opening it back up and repairing the chyle valve was not likely at all as there was probably too much damage. So he said the only place that is not damaged in this feed tube and is original yet is on the right side between the abdomen and the upper chest area. He said he was going on the right side of my chest and it may have been robotic surgery because it was done through small holes or incisions. He said he was going in and bundle tissue with this tube, tie it off somehow and squeeze or pinch it off to slow down the flow to the chyle valve area which he did and thank God it was successful and it started slowing down and in a couple of days was pretty much stopped. And it did stop eventually, and completely and they could finally remove my drain reservoir. I was impressed with the thoracic surgeon, he explained things to you before and after the surgery and had a great bedside manner and treated me well. I looked him up later and found I had a top-notch surgeon in my corner as he is chief of the Division of Thoracic Surgery at Penn State Health Milton S. Hershey Medical Center, a professor of surgery at Penn State College of Medicine and the program director for the Thoracic Surgery Residency program.

I had some other complications but this was the big thing to get the chyle leak stopped. I hope your chyle leak is easier to get stopped but this gives you an idea there are other ways they can go to help you.

Sorry this is so long but I wanted to explain as best I can.

Take Care-God Bless

Wow wbcgaruss! What a journey! I'm glad they were able to stop the leak.  Hopefully, mine is on the mend. I am a week into the fat free diet and so far it seems to be working. Looking forward to the new year. Take care!