Lymphaticovenular-anastomosis treatment of the peripheral component in chyle leakage after axillary surgery: case report and review

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.