Abstract：
BACKGROUND: The complication of brachial plexus injury (BPI) after surgical suture of chylous fistula caused by neck dissection is extremely rare. For the first time, we investigated the treatment and prevention strategy of BPI caused by surgical suture of neck dissection induced chylous fistula.
METHODS: Forty-two patients undergoing surgical suture of neck dissection induced chylous fistula were identified between January 2015 to March 2022 at a single tertiary academic center. All patients were divided into two groups, medial anterior scalene muscle (MASM) group (24 patients) and lateral anterior scalene muscle (LASM) group (18 patients), according to the location of fistula regarding scalene muscle described in the surgical records. The incidence of BPI between the two groups after surgical suture was summarized and compared.
RESULTS: There was significant difference in the incidence of different degrees of BPI between the two groups. In the MASM group, the incidence of BPI was 0 % (0/24), while in the LASM group, 6 cases suffered different degrees of BPI immediately after operation and the incidence of BPI was 33.3 % (6/18) (p < 0.05). The neurological function of all BPI cases recovered within 1-3 months after the suture was removed in time.
CONCLUSIONS: The incidence of BPI in patients of LASM group was significantly higher than that of MASM group. When suturing this kind of fistula, the depth of the needle should be properly controlled to avoid BPI. In case of BPI, the suture should be removed as soon as possible to promote the recovery of neurological function.
METHODS: Forty-two patients undergoing surgical suture of neck dissection induced chylous fistula were identified between January 2015 to March 2022 at a single tertiary academic center. All patients were divided into two groups, medial anterior scalene muscle (MASM) group (24 patients) and lateral anterior scalene muscle (LASM) group (18 patients), according to the location of fistula regarding scalene muscle described in the surgical records. The incidence of BPI between the two groups after surgical suture was summarized and compared.
RESULTS: There was significant difference in the incidence of different degrees of BPI between the two groups. In the MASM group, the incidence of BPI was 0 % (0/24), while in the LASM group, 6 cases suffered different degrees of BPI immediately after operation and the incidence of BPI was 33.3 % (6/18) (p < 0.05). The neurological function of all BPI cases recovered within 1-3 months after the suture was removed in time.
CONCLUSIONS: The incidence of BPI in patients of LASM group was significantly higher than that of MASM group. When suturing this kind of fistula, the depth of the needle should be properly controlled to avoid BPI. In case of BPI, the suture should be removed as soon as possible to promote the recovery of neurological function.
摘要：
背景：颈淋巴结清扫术引起的乳糜瘘手术缝合术后臂丛神经损伤（BPI）的并发症极为罕见。第一次,探讨颈淋巴结清扫手术缝合引起的乳糜瘘的治疗和预防策略。
方法：在2015年1月至2022年3月期间，在一个三级学术中心发现了42例接受手术缝合颈淋巴结清扫术诱导乳糜瘘的患者。将所有患者分为两组,内侧前斜角肌（MASM）组（24例）和外侧前斜角肌（LASM）组（18例），根据手术记录中描述的关于斜角肌的瘘管位置。总结并比较两组患者手术缝合后BPI的发生率。
结果：两组之间不同程度的BPI发生率差异有统计学意义。在MASM组中，BPI的发生率为0%（0/24），而在LASM组，6例术后即刻出现不同程度的BPI,BPI发生率为33.3%(6/18)(p<0.05)。所有BPI病例在及时拆线后1～3个月内神经功能恢复。
结论：LASM组患者BPI的发生率明显高于MASM组。缝合这种瘘管时，应适当控制针头的深度以避免BPI。如果是BPI，应尽快拆除缝线，以促进神经功能的恢复。
方法：在2015年1月至2022年3月期间，在一个三级学术中心发现了42例接受手术缝合颈淋巴结清扫术诱导乳糜瘘的患者。将所有患者分为两组,内侧前斜角肌（MASM）组（24例）和外侧前斜角肌（LASM）组（18例），根据手术记录中描述的关于斜角肌的瘘管位置。总结并比较两组患者手术缝合后BPI的发生率。
结果：两组之间不同程度的BPI发生率差异有统计学意义。在MASM组中，BPI的发生率为0%（0/24），而在LASM组，6例术后即刻出现不同程度的BPI,BPI发生率为33.3%(6/18)(p<0.05)。所有BPI病例在及时拆线后1～3个月内神经功能恢复。
结论：LASM组患者BPI的发生率明显高于MASM组。缝合这种瘘管时，应适当控制针头的深度以避免BPI。如果是BPI，应尽快拆除缝线，以促进神经功能的恢复。
