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

Objective Postoperative chyle fistula is a serious complication following total thyroidectomy and neck dissection. In high-risk patients, the incidence of chyle fistula can reach approximately 3%. Given the uncertain effectiveness of conservative treatments, we aimed to evaluate the short-term efficacy and safety of percutaneous ultrasound-guided pseudomonas aeruginosa-mannose-sensitive hemagglutinin (PA-MSHA) injection in postoperative patients. Methods This retrospective, single-center, controlled trial involved 78 patients with papillary thyroid carcinoma who underwent total thyroidectomy with lateral neck dissection. Patients were divided into two groups: Group A (receiving PA-MSHA injection) and Group B (receiving conservative treatment plus adhesion agent injection). Primary endpoints included postoperative length of stay, number of drug injections, readmission rates, daily drainage volume, and inflammatory responses such as fever and pain associated with PA-MSHA injection therapy. Secondary endpoints included total drainage volume, side of leakage, and demographic data. Results All patients were successfully treated without surgical interventions required. Compared to Group B, Group A showed a significant reduction in length of stay (7.57 ± 1.49 versus 8.86 ± 0.38), readmission rates (7.14% versus 30%), and the need for multiple drug injections (0% versus 50%). Group A patients showed a lower percentage of 37% in overnight drainage volume versus 44% in Group B. On the contrary, Group A had a higher proportion of patients experiencing fever and neck pain, which were effectively managed with oral loxoprofen sodium tablets. Conclusion Percutaneous PA-MSHA injection therapy is a straightforward and effective treatment for managing chyle fistula in postoperative patients, with minimal severe complications and a significant effect on chyle suppression.