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Chylous ascites after colorectal cancer surgery: risk factors and impact on short-term and long-term outcomes

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Abstract

Purpose

Data on the incidence, risk factors, and oncologic impact of chylous ascites after colorectal cancer surgery are scarce. In this study, we aimed to assess the risk factors and the short-term and long-term impact of chylous ascites after colorectal cancer surgery.

Methods

We retrospectively examined 2917 primary colorectal cancer patients who underwent surgical resection between January 2008 and December 2013. The short-term and long-term outcomes were compared between patients with and those without postoperative chylous ascites, and the risk factors for chylous ascites were analyzed.

Results

Chylous ascites developed in 138 (4.7 %) patients. A shorter operative time (odds ratio [OR] 0.992, 95 % confidence interval [CI] 0.988–0.996) and the number of retrieved lymph nodes (OR 1.015, 95 % CI 1.004–1.025) were independent risk factors for postoperative chylous ascites. All patients with chylous ascites were managed conservatively, without surgical intervention. The postoperative hospital stay was similar between the two groups (9.4 vs. 9.2 days, p = 0.467). After a median follow-up of 37 months (range 0–118 months), no significant difference was observed in the 3-year disease-free survival (85.0 vs. 83.9 %, p = 0.408) and 5-year overall survival (93.0 vs. 89.7 %, p = 0.662) between the two groups.

Conclusions

A major drawback of this study was that the definition of chylous ascites was solely based on clinical signs. Nevertheless, we can conclude that chylous ascites after colorectal cancer surgery is associated with a shorter operative time and the number of retrieved lymph nodes, but is not associated with the short-term and long-term outcomes.

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References

  1. Kaas R, Rustman LD, Zoetmulder FA (2001) Chylous ascites after oncological abdominal surgery: incidence and treatment. Eur J Surg Oncol 27:187–189

    Article  CAS  PubMed  Google Scholar 

  2. Cardenas A, Chopra S (2002) Chylous ascites. Am J Gastroenterol 97:1896–1900

    Article  PubMed  Google Scholar 

  3. Baek SJ, Kim SH, Kwak JM, Kim J (2013) Incidence and risk factors of chylous ascites after colorectal cancer surgery. Am J Surg 206:555–559

    Article  PubMed  Google Scholar 

  4. Nishigori H, Ito M, Nishizawa Y, Koyama A, Koda T, Nakajima K, Minagawa N, Nishizawa Y, Kobayashi A, Sugito M, Saito N (2012) Postoperative chylous ascites after colorectal cancer surgery. Surg Today 42:724–728

    Article  PubMed  Google Scholar 

  5. Weniger M, D'Haese JG, Angele MK, Kleespies A, Werner J, Hartwig W (2016) Treatment options for chylous ascites after major abdominal surgery: a systematic review. Am J Surg 211:206–213

    Article  PubMed  Google Scholar 

  6. Matsuda T, Fujita H, Kunimoto Y, Kimura T, Ogino K (2013) Chylous ascites as a complication of laparoscopic colorectal surgery. Asian J Endosc Surg 6:279–284

    Article  PubMed  Google Scholar 

  7. Kim CH, Kim HJ, Huh JW, Kim YJ, Kim HR (2014) Learning curve of laparoscopic low anterior resection in terms of local recurrence. J Surg Oncol 110:989–996

    Article  PubMed  Google Scholar 

  8. Lim SW, Kim HJ, Kim CH, Huh JW, Kim YJ, Kim HR (2013) Umbilical incision laparoscopic colectomy with one additional port for colorectal cancer. Tech Coloproctol 17:193–199

    Article  PubMed  Google Scholar 

  9. Yilmaz M, Akbulut S, Isik B, Ara C, Ozdemir F, Aydin C, Kayaalp C, Yilmaz S (2012) Chylous ascites after liver transplantation: incidence and risk factors. Liver Transpl 18:1046–1052

    Article  PubMed  Google Scholar 

  10. Tulunay G, Ureyen I, Turan T, Karalok A, Kavak D, Ozgul N, Ocalan R, Tapisiz OL, Boran N, Kose MF (2012) Chylous ascites: analysis of 24 patients. Gynecol Oncol 127:191–197

    Article  PubMed  Google Scholar 

  11. Assumpcao L, Cameron JL, Wolfgang CL, Edil B, Choti MA, Herman JM, Geschwind JF, Hong K, Georgiades C, Schulick RD, Pawlik TM (2008) Incidence and management of chyle leaks following pancreatic resection: a high volume single-center institutional experience. J Gastrointest Surg 12:1915–1923

    Article  PubMed  Google Scholar 

  12. Evans JG, Spiess PE, Kamat AM, Wood CG, Hernandez M, Pettaway CA, Dinney CP, Pisters LL (2006) Chylous ascites after post-chemotherapy retroperitoneal lymph node dissection: review of the M. D. Anderson experience. J Urol 176:1463–1467

    Article  PubMed  Google Scholar 

  13. Yol S, Bostanci EB, Ozogul Y, Ulas M, Akoglu M (2005) A rare complication of D3 dissection for gastric carcinoma: chyloperitoneum. Gastric Cancer 8:35–38

    Article  PubMed  Google Scholar 

  14. Omloo JM, Lagarde SM, Vrouenraets BC, Busch OR, van Lanschot JJ (2006) Compartimentalization for chylothorax originating from the abdomen after extended esophagectomy. Report of two cases and review of the literature. Dig Surg 23:86–92

    Article  CAS  PubMed  Google Scholar 

  15. Harold KL, Pollinger H, Matthews BD, Kercher KW, Sing RF, Heniford BT (2003) Comparison of ultrasonic energy, bipolar thermal energy, and vascular clips for the hemostasis of small-, medium-, and large-sized arteries. Surg Endosc 17:1228–1230

    Article  CAS  PubMed  Google Scholar 

  16. van der Gaag NA, Verhaar AC, Haverkort EB, Busch OR, van Gulik TM, Gouma DJ (2008) Chylous ascites after pancreaticoduodenectomy: introduction of a grading system. J Am Coll Surg 207:751–757

    Article  PubMed  Google Scholar 

  17. Ha GW, Lee MR (2015) Surgical repair of intractable chylous ascites following laparoscopic anterior resection. World J Gastroenterol 21:6077–6081

    PubMed  PubMed Central  Google Scholar 

  18. Leibovitch I, Mor Y, Golomb J, Ramon J (2002) The diagnosis and management of postoperative chylous ascites. J Urol 167:449–457

    Article  PubMed  Google Scholar 

  19. Lu J, Wei ZQ, Huang CM, Zheng CH, Li P, Xie JW, Wang JB, Lin JX, Chen QY, Cao LL, Lin M (2015) Small-volume chylous ascites after laparoscopic radical gastrectomy for gastric cancer: results from a large population-based sample. World J Gastroenterol 21:2425–2432

    Article  PubMed  PubMed Central  Google Scholar 

  20. Zhang HY, Zhao CL, Xie J, Ye YW, Sun JF, Ding ZH, Xu HN, Ding L (2016) To drain or not to drain in colorectal anastomosis: a meta-analysis. Int J Color Dis 31:951–960

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-ro Hwasun-eup, Hwasun-gun Jeonnam, Gwangju, 58128, South Korea

    Soo Young Lee, Chang Hyun Kim, Young Jin Kim & Hyeong Rok Kim

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  1. Soo Young Lee
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  2. Chang Hyun Kim
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  3. Young Jin Kim
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Correspondence to Hyeong Rok Kim.

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Disclosure

The authors received no financial support for this study. The authors declare no conflicts of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was exempted because this retrospective study was harmless to the patients and contained no personal data. It was approved by the institutional review board of our institution.

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Lee, S.Y., Kim, C.H., Kim, Y.J. et al. Chylous ascites after colorectal cancer surgery: risk factors and impact on short-term and long-term outcomes. Langenbecks Arch Surg 401, 1171–1177 (2016). https://doi.org/10.1007/s00423-016-1500-6

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  • DOI: https://doi.org/10.1007/s00423-016-1500-6

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