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Risk factors of chylous ascites and its relationship with long-term prognosis in laparoscopic D3 lymphadenectomy for right colon cancer

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Abstract

Background

Chylous ascites (CA) after laparoscopic D3 lymphadenectomy for right colon cancer is not rare. However, the risk factors for CA have not been fully explored. Few studies have investigated the effect of CA on long-term prognosis.

Methods

The clinical data of patients with right colon cancer who underwent laparoscopic D3 lymphadenectomy in five centers from January 2013 to December 2018 were retrospectively collected. Univariate and multivariate analyses were performed to determine the clinicopathological factors associated with CA. Then, the long-term prognosis of patients with and without CA was compared by propensity score matching and Kaplan–Meier survival analysis.

Results

The incidence of CA was 4.4% (48/1090). Pathological T stage (p = 0.025), dissection along the left side of the superior mesenteric artery (p < 0.001) and the number of retrieved lymph nodes (p < 0.001) were independent risk factors for CA. After propensity score matching, 48 patients in the CA group and 353 patients in the non-CA group were enrolled. Kaplan–Meier survival analysis indicated that CA was not associated with overall survival (p = 0.454) and disease-free survival (p = 0.163). In patients with stage III right colon cancer, there were no significant differences in overall survival (p = 0.501) and disease-free survival (p = 0.254).

Conclusions

Pathological T stage, number of retrieved lymph nodes, and left side dissection along the superior mesenteric artery were independent risk factors for CA after laparoscopic D3 lymphadenectomy. CA does not impair the oncological outcomes of patients.

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Funding

This work was supported by the Natural Science Fund of Shanghai (grant number: 18ZR1424100) and National Facility for Translational Medicine (Shanghai) (TMSK-2021-503).

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Author notes

  1. Wei Qin, Dechang Diao, Kai Ye and Ximo Xu contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin Er Road, Shanghai, 200025, China

    Wei Qin, Ximo Xu, Duohuo Shu, Hao Zhong, Yanyan Hu, Xiao Yang, Batuer Aikemu, Leqi Zhou, Sen Zhang, Pei Xue, Zhenghao Cai, Minhua Zheng, Jianwen Li & Bo Feng

  2. Department of Gastrointestinal (Tumor) Surgery, Guangdong Province Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China

    Dechang Diao

  3. Department of Oncological Surgery, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, China

    Kai Ye

  4. Gastric and Intestinal Department of the First Hospital of Jilin University, Changchun, China

    Quan Wang

  5. Department of Colorectal, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

    Yueming Sun

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Correspondence to Jianwen Li, Quan Wang, Yueming Sun or Bo Feng.

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Qin, W., Diao, D., Ye, K. et al. Risk factors of chylous ascites and its relationship with long-term prognosis in laparoscopic D3 lymphadenectomy for right colon cancer. Langenbecks Arch Surg 407, 2453–2462 (2022). https://doi.org/10.1007/s00423-022-02527-3

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