Chylous ascites after laparoscopic lymph node dissection in gynecologic malignancies.

Abstract

STUDY OBJECTIVE:

To evaluate the clinical presentation, epidemiology, risk factors, and treatment of chylous ascites after laparoscopic lymphadenectomy to treat gynecologic malignancies.

DESIGN:

Retrospective study with review of outcomes (Canadian Task Force classification II-3).

SETTING:

University research hospital.

PATIENTS:

From November 2009 to December 2012, 997 patients underwent laparoscopic lymphadenectomy to treat gynecologic malignancies at our hospital.

INTERVENTIONS:

Postoperative chylous ascites resolved with continuous drainage and dietary restriction or fasting.

MEASUREMENTS AND MAIN RESULTS:

Nine of 997 patients (0.9%) developed chylous ascites postoperatively. Mean age of these 9 patients was 47.5 years. Median time from operation to development of chylous ascites was 4 days (range, 2-9 days). Chylous ascites developed on either day 1 in 6 patients, day 2 in 2 patients, and day 8 in 1 patient, after food intake. We found that postoperative chylous ascites was associated more with para-aortic lymphadenectomy than with pelvic lymphadenectomy (overall incidence, 0.9%; 4.08% in the para-aortic lymphadenectomy group vs 0.35% in the pelvic lymphadenectomy group). In all patients, chylous ascites resolved with conservative treatment. Median time to resolution was 7 days (range, 3-9 days). Drainage tubes were removed within 9 days after treatment.

CONCLUSIONS:

The incidence of chylous ascites after laparoscopic lymphadenectomy was 0.9%. Para-aortic lymphadenectomy was associated with postoperative chylous ascites. Chylous ascites was successfully treated with conservative management. An abdominal drainage tube can be a simple and effective approach and should be considered in the treatment of chylous ascites.

• Authors: Yuqing Zhao, Weiguo Hu, Xiaofan Hou, Qi Zhou
• Journal: Journal of minimally invasive gynecology (J Minim Invasive Gynecol) 2014 Jan-Feb Vol. 21 Issue 1 Pg. 90-6 ISSN: 1553-4669 [Electronic] United States
• PMID: 23900043 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Chylous Ascites (etiology, therapy)
• Drainage
• Female
• Genital Neoplasms, Female (pathology, surgery)
• Humans
• Laparoscopy (adverse effects)
• Lymph Node Excision (adverse effects)
• Middle Aged
• Retrospective Studies
• Risk Factors