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Drobot et al. Plast Aesthet Res 2021;8:30 Plastic and
DOI: 10.20517/2347-9264.2021.19
Aesthetic Research

Case Report Open Access

Lymphaticovenular-anastomosis treatment of the
peripheral component in chyle leakage after axillary

surgery: case report and review

1,2
4,5
2
4,5
2,3
4,5
Assi Drobot , Denis Drobot , Omer Itzhak Sagi , Elchanan Bruckheimer , Einav Cohen , Eli Atar , Eli
Kakiashvili 2,6,7
1
Department of Surgery A, Galilee Medical Center, Nahariya 22100, Israel.
2
The Azrieli Faculty of Medicine, Bar Ilan University, Safed 1311502, Israel.
3
Department of Plastic Surgery, Western Galilee Medical Center, Nahariya 22100, Israel.
4
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
5
Pediatric Cardiology and Invasive Radiology, schneider Children’s Medical Center Israel, Petach Tikva 4920235, Israel.
6
Department of Surgery A, Galilee Medical Center, Nahariya 22100, Israel.
7
Medical Corps, Israel Defense Forces, Ramat Gan 25737, Israel.
Correspondence to: Dr. Assi Drobot, Department of Surgery A, Galilee Medical Center, Nahariya 22100, Israel.
E-mail: assi.drobot@gmail.com
How to cite this article: Drobot A, Drobot D, Sagi OI, Bruckheimer E, Cohen E, Atar E, Kakiashvili E. Lymphaticovenular-
anastomosis treatment of the peripheral component in chyle leakage after axillary surgery: case report and review. Plast Aesthet
Res 2021;8:30. https://dx.doi.org/10.20517/2347-9264.2021.19
Received: 5 Mar 2021 First Decision: 30 Mar 2021 Revised: 6 April 2021 Accepted: 10 May 2021 Published: 23 Jun 2021
Academic Editors: Isao Koshima, Matthew L Iorio Copy Editor: Yue-Yue Zhang Production Editor: Yue-Yue Zhang
Abstract
Axillary lymph node dissection-dependent chyle leakage is a rare complication with an incidence of < 0.7%. The
morbidity could be high, and the management prolonged and not clear. The literature offers us many therapeutical
tools, yet there is no consensus about the management of this complication. Usually, the management focuses on
reducing the chyle flow in the thoracic duct (central origin), neglecting the possibility of a parallel lymphorrhea
from other regional lymphatic vessels (peripheral origin), which causes a prolonged approach with high morbidity.
In this paper, we introduce the supermicrosurgery technique as a surgical therapeutic option for chyle leakage. To
decrease morbidity and shorten treatment duration, we offer a therapeutic algorithm based on the literature and
our experience.

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
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