THORACIC DUCT INJURY IN NECK DISSECTION SURGERY: ANALYSING FREQUENCY AND ITS MANAGEMENT TECHNIQUES

Background: Chyle leak is an uncommon yet potentially serious complication following neck dissection, particularly in procedures involving the left side and level IV lymph node clearance. It can result in signicant postoperative morbidity, including malnutrition, electrolyte imbalance, and extended hospitalization. Despite its clinical importance, there is limited consensus on standardized management approaches, especially in stratifying conservative versus surgical interventions. This prospective cross-sectional observational study was Methods: conducted in the Department of Surgical Oncology at Sri Aurobindo Institute of Medical Sciences (SAIMS), Indore, between January and December 2024. A total of 200 patients with head and neck malignancies undergoing left-sided neck dissection were enrolled. All patients were monitored for intraoperative and postoperative chyle leak. Leaks were categorized based on daily output as low-output (<500 mL/day) or high-output (>500 mL/day). Management strategies included conservative treatment (dietary modications, total parenteral nutrition, pressure dressings, and octreotide) or surgical re-exploration as indicated. Statistical analysis was performed using SPSS version 25.0. Chyle leak occurred in 12 patients (6%), while 11 (5 Results: .5%) had intraoperative chyle duct injury, all managed successfully with ligation. A statistically signicant association was noted between chyle leak and the type of neck dissection (p=0.0028), level IV nodal metastasis (p<0.0001), and prior chemoradiotherapy (p=0.0002). Conservative management succeeded in 8 patients (66.6%), whereas 3 of 4 patients with highoutput leaks required surgical intervention and achieved resolution within 48 hours. Chyle leak rema Conclusion: ins a clinically relevant complication following neck dissection. Risk-based stratication and early intraoperative recognition allow for effective conservative or surgical management, optimizing outcomes and reducing morbidity.