{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:06:21Z","timestamp":1791644781300,"version":"4.3.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T00:00:00Z","timestamp":1753747200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lateral neck lymph node dissection (LLND) for thyroid carcinoma can result in chylous fistula, a complication with limited preventative surgical techniques. This study aimed to evaluate the impact of a novel surgical technique, reverse-sequence dissection and protection of the thoracic duct or right lymphatic duct, in reducing chylous fistula incidence post-LLND.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included 989 patients who underwent LLND between October 2019 and February 2024. Patients were divided into two groups based on the surgical technique: Group A (reverse-sequence dissection and protection of the thoracic duct and\/or right lymphatic duct; n = 494) and Group B (prophylactic ligation of tissue around the venous angle; n = 495). The primary outcome was postoperative chylous fistula incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The chylous fistula rate in group A (0.81%) was significantly lower compared to group B (5.05%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0001). Group A had a significantly lower median peak output of 24-hour chylous fistula (32.50 [30.00, 36.25] ml\/day vs 67.00 [55.00, 75.00] ml\/day,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0188).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The reverse-sequence dissection technique, combined with protection of the thoracic duct and\/or the right lymphatic duct, effectively reduces the occurrence of chylous fistula following LLND for thyroid carcinoma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251363529","type":"journal-article","created":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T09:18:06Z","timestamp":1753780686000},"page":"322-328","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["A Novel Technique for Reducing the Occurrence of Chylous Fistula After Lateral Neck Lymph Node Dissection for Thyroid Carcinoma: Reverse-Sequence Dissection and Protection of the Thoracic Duct and Right Lymphatic Duct"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9731-1337","authenticated-orcid":false,"given":"Liping","family":"Liu","sequence":"first","affiliation":[{"name":"Guiqian International Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoxi","family":"Liu","sequence":"additional","affiliation":[{"name":"Guiqian International Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhou","sequence":"additional","affiliation":[{"name":"Guiqian International Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinhua","family":"Yang","sequence":"additional","affiliation":[{"name":"Guiqian International Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiwei","family":"Zhao","sequence":"additional","affiliation":[{"name":"Guiqian International Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Liu","sequence":"additional","affiliation":[{"name":"Guiqian International Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dehao","family":"Yu","sequence":"additional","affiliation":[{"name":"Guiqian International Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,29]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-008-0017-9"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23104"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24852"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2023.1269301"},{"issue":"4","key":"e_1_3_4_6_2","first-page":"343","article-title":"A contemporary review of chylothorax","volume":"50","author":"Talwar A","year":"2008","unstructured":"Talwar A, Lee HJ. A contemporary review of chylothorax. Indian J Chest Dis Allied Sci. 2008;50(4):343-351.","journal-title":"Indian J Chest Dis Allied Sci"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(00)70061-1"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2011.02.001"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21979"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2015.03.066"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.05.058"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2016.02.025"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.neu.0000093826.31666.a5"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thorsurg.2011.01.002"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1993.tb00041.x"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2007.03.003"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-011-0015-6"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.05.058"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251363529","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251363529","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251363529","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:38:16Z","timestamp":1777379896000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251363529"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,29]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1177\/00031348251363529"],"URL":"https:\/\/doi.org\/10.1177\/00031348251363529","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,29]]}}}