Short-term efficacy and safety of percutaneous ultrasound-guided pseudomonas aeruginosa-mannose sensitive hemagglutinin injection in postoperative chyle fistula: a cohort study - Report - MDSpire

Short-term assessment of safety and effectiveness of ultrasound-guided PA-MSHA injection for managing postoperative chyle fistula: A cohort analysis

  • By

  • Yuhan Chen

  • Shouyi Yan

  • Tenghong Liu

  • Wenxin Zhao

  • May 18, 2026

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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

ParameterPA-MSHA (Group A)Conservative Management (Group B)
Length of Stay (LOS)7.57 ± 1.49 days8.86 ± 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.

Related Resources & Content

  1. Journal of Gastrointestinal Surgery, 2022 -- Impact of Ultrasound-Guided Transversus Abdominis Plane Block in Combination with Patient-Controlled Intravenous Analgesia on Postoperative Pain Management Following Laparoscopic Cholecystectomy: A Double-Blind, Randomized Trial
  2. Surgical Endoscopy, 2021 -- Evaluation of Surgical Site Infection Incidence in Transumbilical Versus Periumbilical Incisions During Laparoscopic Cholecystectomy: A Randomized Controlled Study
  3. Neck Cancer Resection and Dissection - StatPearls - NCBI Bookshelf
  4. Improving the management of cervical chyle leak following neck dissection, The Journal of Laryngology & Otology
  5. Frontiers, 2025 -- Pseudomonas aeruginosa injection for the treatment of chyle fistula following neck dissection in thyroid cancer
  6. Effect of Pulmonary Recruitment Maneuver on Postoperative Shoulder Pain and Nausea Following Laparoscopic Cholecystectomy: Results from a Randomized Controlled Study
  7. Efficacy of Antibiotic Prophylaxis in Elective Cholecystectomy: Insights from a Population-Based Cohort Analysis
  8. Postoperative cervical chyle fistula management guidelines
  9. Improving the management of cervical chyle leak following neck dissection | The Journal of Laryngology & Otology | Cambridge Core
  10. Frontiers | Pseudomonas aeruginosa injection for the treatment of chyle fistula following neck dissection in thyroid cancer

Original Source(s)

Short-term efficacy and safety of percutaneous ultrasound-guided pseudomonas aeruginosa-mannose sensitive hemagglutinin injection in postoperative chyle fistula: a cohort study

  • by Yuhan Chen, Shouyi Yan, Tenghong Liu, Wenxin Zhao

  • May 18, 2026

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