A novel therapeutic strategy for chylous ascites after gynecological cancer surgery: a continuous low-pressure drainage system

Purpose Postoperative chylous ascites is an unusual complication following retroperitoneal surgery. A search of the English literature showed only 44 cases of chylous ascites following gynecological cancer surgery. The treatment is primarily conservative, but surgical treatment is considered in resi...

Full description

Saved in:
Bibliographic Details
Published in:Archives of gynecology and obstetrics 2013-05, Vol.287 (5), p.1005-1008
Main Authors: Shibuya, Yusuke, Asano, Koh, Hayasaka, Atsushi, Shima, Takashi, Akagi, Kozo, Ozawa, Nobuyoshi, Wada, Yuichi
Format: Article
Language:English
Subjects:
Biopsy
Cancer surgery
Carcinoma, Endometrioid - surgery
Chemotherapy, Adjuvant
Chylous Ascites - etiology
Chylous Ascites - therapy
Dissection
Drainage - methods
Endocrinology
Endometrial cancer
Female
Gynecologic Oncology
Gynecologic Surgical Procedures - adverse effects
Gynecological cancer
Gynecology
Human Genetics
Humans
Lymph Node Excision - adverse effects
Lymphatic system
Medicine
Medicine & Public Health
Middle Aged
Obstetrics/Perinatology/Midwifery
Paracentesis
Pelvis
Postoperative Complications - therapy
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose Postoperative chylous ascites is an unusual complication following retroperitoneal surgery. A search of the English literature showed only 44 cases of chylous ascites following gynecological cancer surgery. The treatment is primarily conservative, but surgical treatment is considered in resistant cases. We developed a novel non-surgical therapeutic strategy for postoperative chylous ascites. Methods We report a case of severe chylous ascites following pelvic lymph node dissection for gynecological cancer. Results Total abdominal hysterectomy, bilateral salpingo-oophorectomy, peritoneal washing, and systematic pelvic lymph node dissection were performed for a stage II G1 endometrioid adenocarcinoma (FIGO 2009). Forty-one days after surgery, the patient was readmitted due to massive ascites. Repeated paracentesis and a low-fat diet were only partially effective. Fifty-one days after surgery, we started paracentesis with a continuous low-pressure drainage system. Nine days later, there was no further fluid drainage. The patient was asymptomatic and without recurrent disease at follow-up 3 months later. Conclusions Pelvic lymph node dissection may cause postoperative chylous ascites. Paracentesis with a continuous low-pressure drainage system can be an effective conservative treatment for postoperative chylous ascites.
ISSN:0932-0067
1432-0711
DOI:10.1007/s00404-012-2666-y