Postoperative chylous ascites in patients with gynecologic malignancies

Abstract

Objective: To evaluate the incidence and the effective treatment of postoperative chylous ascites in patients with gynecologic malignancies. Methods: In this report, we retrospectively reviewed the cases of 4119 patients who underwent pelvic and/or para-aortic lymph node dissection for gynecologic malignancies in Fudan University Cancer Hospital. Results: Among these 4119 cases, 7 (0.17%) patients had chylous ascites postoperatively. The average age of these patients was 52 years. The mean time interval between operation and the appearance of chylous ascites was 30 days (range, 5-75 days). The incidence of chylous ascites after para-aortic lymphadenectomy was approximately 0.32% (5/1540), whereas the rate after pelvic lymphadenectomy alone was 0.077% (2/2579). All cases with chylous ascites were resolved by conservative treatment. This included placement of a peritoneal drainage tube. The mean time to resolution was 13 days (range, 2-28 days). None of the cases had recurrent chylous ascites during follow-up. Conclusions: 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. Copyright © 2012 by IGCS and ESGO.