Direct repair of iatrogenic thoracic duct injury through lymphovenous anastomosis (LVA): A case report

This is a case report of a 64-year-old male with cancer with an unknown primary and bilateral cervical lymph node metastases. Twelve months after chemo-, radio-, immunotherapy, and radical neck dissection, he presented with recurrent cervical metastases. The patient underwent radical revision neck dissection including the deep neck muscles of the cervical plexus and reconstruction with a free anterolateral thigh flap. During tumor resection, parts of the thoracic duct were removed which resulted in a large lymph leak. This was addressed by creating a lymphovenous anastomosis to a branch of the subclavian vein. The flow of lymph was reinstated, and no leak has been observed up to a recent 6-month follow-up.