Chyle leak following surgery for abdominal neuroblastoma

Qureshi, Sajid; Rent, Eugene G.; Bhagat, Monica; Dsouza, Priyanka; Kembhavi, Seema; Vora, Tushar; Prasad, Maya; Chinnaswamy, Girish; Ramadwar, Mukta; Laskar, Siddharth; Khanna, Nehal; Shah, Sneha; Talole, Sanjay

doi:10.1016/j.jpedsurg.2015.11.002

Cited by 22 publications

(22 citation statements)

References 16 publications

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“…Different incidences of postoperative chylous ascites have been analyzed in many surgeries including post-chemotherapy laparoscopic retroperitoneal lymph nodes dissection testicular cancer (23 of 329 patients, 7%) [ 63 ], or for stage IIB nonseminomatous testicular cancer (5 of 24 patients, 20.8%) [ 64 ] high incidence probably due to lymphatic metastases; surgery for abdominal neuroblastoma (32 of 160 patients, 20%) [ 65 ]; surgery for colorectal cancer (48 of 779 patients, 6%) [ 66 ]; retroperitoneal lymphadenectomy (24 of 1258 patients, 2%) [ 58 ]; laparoscopic donor nephrectomy (10 of 4636 patients, 2%), open donor nephrectomy (2 of 3047 patients, 0.6%) [ 61 ], laparoscopic nephrectomies (9 of 1159 patients, 0.77%) [ 67 ]; gynecological surgery with pelvic or/and para-aortic lymph node dissection (7 of 4119 patients, 0.17 %) [ 23 ]; and pancreatic resection (49 of 1921 patients 2.6%) [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…What's more, abdominal aortic surgery is said to be the most common etiology of postoperative chylous ascites, and causes 81% of all chylous complications due to the surgical injury of the retroperitoneal lymphatic glands or cisterna chyli [ 59 ]. Lymphatic metastases, number of lymph nodes removed and damage of lymphatic channels may increase the incidence of lymphatic leakage [ 64 , 65 ]. This view needs more supports of clinical data.…”

Section: Resultsmentioning

confidence: 99%

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A review of the postoperative lymphatic leakage

et al. 2017

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Lymphatic complications are rare, but well-known phenomena, and have been described by many researchers. However, many diagnoses of lymphatic complications are found confusing due to different definition. A literature search in Pubmed was performed for studies postoperative lympatic complications. These complications divided into two parts: lymphatic leakage and lymphatic stasis. This review is about lymphatic leakage, especially, postoperative lymphatic leakage due to the injury of lymphatic channels in surgical procedures. According to polytrophic consequences, many types of postoperative lymphatic leakage have been presented, including lymph ascites, lymphocele, lymphorrhea, lymphatic fistula, chylous ascites, chylothorax, chyloretroperitoneum and chylorrhea. In this review, we focus on the definition, incidence and treatment about most of these forms of lymphatic complications to depict a comprehensive view of postoperative lymphatic leakage. We hold the idea that the method of treatment should be individual and personal according to manifestation and tolerance of patient. Meanwhile, conservative treatment is suitable and should be considered first.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A review of the postoperative lymphatic leakage

et al. 2017

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“…LL is a known complication after surgery for diseases that require intra-abdominal surgery, as Wilms' tumor, neuroblastoma, intra-abdominal teratoma, choledochal cyst resection, and renal transplantation are recognized for. 3,[14][15][16][17] While there is a multitude of scientific reports regarding chyle leak in the adult population, only little is known about this problem in pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

“…7 Qureshi et al defined LL as a high drain output with milky-white fluid. 3 Chui defined LL as drainage of more than 400 mL/day after beginning with a fat-containing diet. Other groups gave no further definition of LL in their reports.…”

Section: Incidence and Definition Of Lymphatic Leakagementioning

confidence: 99%

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Lymphatic Leakage after Surgery for Neuroblastoma: A Rare Complication?

Froeba-Pohl

Muehling

Vill³

et al. 2020

Eur J Pediatr Surg

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Introduction Neuroblastoma is the most common extracranial solid tumor in infancy. It is responsible for around 15% of all oncological deaths during childhood. Due to its retroperitoneal location, neuroblastoma is invasively growing directly in and around the lymphatic duct. Consecutively, lymphatic leakage (LL) after surgery for neuroblastoma is a known complication. The purpose of this study is the investigation of frequency and impact of this complication. Material and Methods Between February 2003 and December 2016, 204 patients with neuroblastoma received surgical treatment in our department. A retrospective analysis for macroscopical extent of resection, duration of drainage postsurgery, maximum amount of fluid drained in 24 hours, MYCN amplification status, therapeutic options for LL, follow-up status, and overall survival was performed. Results A total of 40% of patients (82/204) showed LL to some extent. In patients with MYCN amplification, LL was seen significantly more often than in patients without MYCN amplification status (p = 0.019). LL was also significantly correlated with extent of surgery (p = 0.005). Follow-up status and overall survival were significantly inversely associated with LL (p = 0.004 and p = 0.0001). LL was self-limiting in all cases. There was a trend toward shorter duration of LL if either no special therapy was chosen or total parenteral nutrition (TPN) was administered (p = 0.0603). Conclusion We show that LL in neuroblastoma is a common complication of tumor resection and occurring more often than anticipated. Since, in our study cohort, all cases of LL were self-limiting, we question the indication for invasive therapy besides supporting measures.

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Complications of the Surgical Management of Children with Neuroblastoma

Davidoff

2019

Neuroblastoma

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Chyle leak following surgery for abdominal neuroblastoma

Cited by 22 publications

References 16 publications

A review of the postoperative lymphatic leakage

A review of the postoperative lymphatic leakage

Lymphatic Leakage after Surgery for Neuroblastoma: A Rare Complication?

Complications of the Surgical Management of Children with Neuroblastoma

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