Chylous ascites after lymphadenectomy for gynecological malignancies

Abstract

Postoperative chylous ascites was more frequently observed in patients with laparoscopic SAPL in comparison with open SAPL and was strongly associated with a larger mean number of removed lymph nodes. J. Surg. Oncol. 2016;114:613-618. © 2016 Wiley Periodicals, Inc.

Does BLOODCARE Powder Prevent Postoperative Chylous Ascites After Lymphadenectomy for Gynecological Malignancies?

“…In all patients, type III bilateral pelvic lymph node dissection was performed according to the classification of Cibula and Abu Rustum. 8 The para-aortic lymph nodes were dissected, and all lymph nodeYbearing tissues were harvested from the lateral, medial, anterior, and posterior aspects of the inferior vena cava and aorta up to the left renal vein. The inferior mesenteric artery was visualized and preserved.…”

Successful Laparoscopic Treatment of Chylous Ascites after Pelvic Lymphadenectomy: A Case Report and Peanut Oil Application

“…The incidence of chylous ascites ranges from 0.17% to 3% after pelvic surgery for gynecologic malignancies [3,4], lower than after colorectal, hepatic, and pancreatic surgeries, which were reported to be as high as 11%. However, the true incidence of lymphatic ascites in patients with gynecologic malignancies is not well established because many cases may be subclinical and resolve spontaneously.…”

“…The symptoms of abdominal distention or signs of chylous fluid from drainage occur days to months after surgery. The median interval from surgery to symptoms was reported to be about 5 days (range, 1-53 days) [4]. The drainage of chylous ascites is milky white in appearance, and laboratory analysis reveals a significantly elevated triglyceride level.…”

“…Because chylous ascites is a rare condition, management recommendations remain controversial. Most cases of chylous ascites after surgeries for gynecologic malignancies [4,[6][7][8][9][10] were reported to be amendable by conservative treatments, including a high-protein, low-fat diet with medium-chain triglycerides or total parental nutrition with or without somatostatin [3]. The objective is to decrease the intestinal lymphatic flow and triglyceride transport, thereby preventing lymphatic accumulation.…”

Microsurgical lymphaticovenular anastomosis for refractory chylous ascites following para-aortic lymph nodes dissection in a patient with tubal cancer

“…It is caused by operative trauma to the cisterna chyli or lymphatic vessels in the retroperitoneum and is commonly characterized by postoperative accumulation of chyle in the peritoneal cavity and appearance of milky fluid in the peritoneal drains ( Aalami et al, 2000 ; Kaas et al, 2001 ). The incidence of chylous ascites is not well defined; however, reported incidence is 2–7.4% following surgical treatment for gynecologicl malignancies ( Thie et al, 2016 ; Baiocchi et al, 2010 ). Although chylous ascites is a widespread problem, there are few reports in the literature and no guidelines or general therapy recommendations.…”