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

Yusuke Shibuya, Koh Asano, Atsushi Hayasaka, Takashi Shima, Kozo Akagi, Nobuyoshi Ozawa, Yuichi Wada

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1005-1008
Number of pages4
JournalArchives of Gynecology and Obstetrics
Volume287
Issue number5
DOIs
Publication statusPublished - 2013 May
Externally publishedYes

Keywords

  • Chylous ascites
  • Conservative treatment
  • Continuous low-pressure drainage system
  • Gynecologic cancer
  • Lymph node dissection
  • Serial paracentesis

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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