Postoperative Chylous Ascites in Patients With Gynecologic Malignancies

Abstract

Para-aortic lymph node dissection may be associated with postoperative chylous ascites. Patients may have their chylous ascites successfully treated with conservative management. An abdominal drainage tube can be a simple and effective approach and should be considered in the treatment.

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

“…According to the literature the risk for postoperative chylous ascites increases in extended resections, since it correlates with the number of lymph nodes harvested (5,11,15,21), concomitant vascular resection (15,39) or manipulation of the paraaortic area (3,12), retroperitoneal tumor invasion (12), and increased blood loss (25). In line with this, a history of chronic pancreatitis (1) was also associated with an increased risk.…”

“…While the reported incidence is remarkably low in gynecologic surgery (3)(4)(5), up to 6.6% of patients in colorectal surgery (8) incidence of postoperative chylous ascites are published for pancreatic surgery, in which the incidence of chylous ascites seems to be highest. This is due to the necessity of an extensive dissection of lymphatic tissue along the superior mesenteric artery and the celiac trunk and the proximity of the surgical field to the cisterna chyli in oncologic pancreatic surgery.…”

“…Incidence of chylous ascites ranged from 0.17% to 2% in gynecological pelvic surgery (3)(4)(5), 1.0% to 6.6% in colorectal surgery (6-8), 4.7% in hepatic surgery including liver transplantation (9), 3.8% to 5.1% in nephrectomy (10,11), and 1.0% to 11% in pancreatic surgery (1, [12][13][14][15][16][17][18][19]. The incidence of chylous ascites in patients with abdominal drainage after pancreatic surgery did not differ significantly from those patients without drainage (20).…”

Recurrent lymphatic ascites in a patient cured of cervical carcinoma

“…Abdominal aortic surgery accounts for approximately 1.2-8.2% of ascitic cases (Combe et al, 1992;Han et al, 2012). In gynecologic cancer, a pelvic and para-aortic lymphadenectomy are frequently performed in the management of endometrial and cervical cancer.…”

“…In gynecologic cancer, a pelvic and para-aortic lymphadenectomy are frequently performed in the management of endometrial and cervical cancer. Complications associated with these procedures include hemorrhage, major vessel injury, lymphedema and lymphocyst formation, all of which can precipitate the extravasation of lymphatic fluid (Krishnan et al, 2001;Combe et al, 1992;Han et al, 2012).…”