Chylous ascites as a complication of laparoscopic colorectal surgery

Abstract

Chylous ascites are not a rare complication of laparoscopic colorectal surgery. It was managed conservatively in all cases but was associated with longer hospital stays. We recommend careful tissue dissection at a suitable plane and meticulous clipping during lymphadenectomy to prevent chyle leakage when lymphatic invasion is suspected.

Treatment options for chylous ascites after major abdominal surgery: a systematic review

“…This is in line with findings that show an unimpaired 3-year survival of patients with chylous ascites in colorectal surgery (7). Nonetheless, chylous ascites prolongs the length of hospital stay (7) and significantly increases treatment costs, and therefore an early and consequent therapeutic approach should be sought.…”

“…However, the absolute number of patients with chylous ascites was low in this study (n=9), and the 3-year overall survival was not impaired (7). In pancreatic surgery, those patients with contained chyle leaks had a 3-year-survival comparable to those patients without any chylous fistula (46.9% vs. 53.4%) (15).…”

“…A significantly increased tumor recurrence rate (22.2% vs. 3.9%) and a reduced 3-year disease free survival rate (76.2% vs. 93.4%) has been reported in colorectal cancer surgery by Matsuda et al (7).…”

“…12 postoperative chylous ascites in laparoscopic colorectal surgery (7). An increased length of stay was also reported for patients after pancreaticoduodenectomy and lymph fistula (15 vs. 12 days) (1).…”

Use of indocyanine green in the surgical treatment of chylous ascites after laparoscopic colectomy

“…Postoperative chylous ascites is an infrequent condition resulting from operative trauma and is caused by the unrecognized interruption of lymphatic vessels. This complication is associated with a prolonged length of hospital stay and, in the case of oncological disease, with a worse 3‐year survival because of delayed administration of adjuvant chemotherapy .…”