Short-term efficacy and safety of percutaneous ultrasound-guided pseudomonas aeruginosa-mannose sensitive hemagglutinin injection in postoperative chyle fistula: a cohort study - Report - MDSpire
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Short-term efficacy and safety of percutaneous ultrasound-guided pseudomonas aeruginosa-mannose sensitive hemagglutinin injection in postoperative chyle fistula: a cohort study
Clinical Report: Short-term assessment of PA-MSHA injection for chyle fistula
Overview
This study evaluates the safety and effectiveness of ultrasound-guided PA-MSHA injection for managing postoperative chyle fistula in patients after total thyroidectomy. Results indicate that PA-MSHA therapy significantly reduces hospital stay compared to conservative management, with no major complications reported.
Background
Postoperative chyle fistula is a rare but serious complication following thyroid surgery, affecting 3%–8% of high-risk patients. Traditional conservative management often yields inconsistent results, necessitating alternative treatment strategies. The introduction of PA-MSHA injection presents a potential adjunctive therapy that may improve patient outcomes.
Data Highlights
Parameter
PA-MSHA (Group A)
Conservative Management (Group B)
Length of Stay (LOS)
7.57 ± 1.49 days
8.86 ± 0.38 days
Chyle Output Reduction Rate (POD3 to POD2)
37%
44%
Key Findings
PA-MSHA injection resulted in a shorter length of hospital stay compared to conservative management.
All patients recovered without the need for surgical re-intervention.
Daily chyle output significantly decreased within 24–48 hours post-PA-MSHA injection.
Pyrexia and cervical discomfort were more common in the PA-MSHA group.
No major complications were observed in either treatment group.
Clinical Implications
Ultrasound-guided PA-MSHA injection may serve as an effective alternative to conservative management for postoperative chyle fistula, particularly in reducing hospital stay. Clinicians should consider this approach in high-risk patients who do not respond adequately to standard therapies.
Conclusion
The findings support the use of PA-MSHA injection as a viable treatment option for postoperative chyle fistula, warranting further prospective studies to validate its effectiveness and refine clinical application.
Most surgeons reported using intraoperative parathyroid hormone monitoring, but approaches to imaging and intraoperative criteria varied, particularly in secondary and tertiary disease
