Archives of gynecology and obstetrics · 2009
Chylous ascites in gynecologic malignancies: cases report and literature review.
Клинический случайСтатьяОбзорНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Baiocchi Glauco, Faloppa Carlos Chaves, Araujo Raphael Leonardo Cunha, Fukazawa Elza Mieko, Kumagai Lillian Yuri, Menezes Ademir Narciso Oliveira, Badiglian-Filho Levon
Аннотация
PURPOSE: Chylous ascites is an infrequent postoperative complication after retroperitoneal surgical procedure. Despite its infrequent occurrence, postoperative chylous ascites are associated with significant morbidity. Reports of chylous ascites or fistula after retroperitoneal lymph node dissection for gynecologic malignancies without radiation therapy are rare. A search in the English literature showed only 31 cases of chylous fistula for gynecologic malignancies. Treatment may be conservative with low-fat oral diet with medium-chain triglycerides associated or not to octreotide and total parenteral nutrition. In case of conservative measures failure, it can be managed by surgical intervention or peritoneo-venous shunt.
METHODS: We report two cases of chylous fistula following systematic pelvic and retroperitoneal lymph node dissection for gynecological cancer without radiotherapy and review the literature.
RESULTS: Both were successfully managed with the maintenance of the postoperative drain, total parenteral nutrition, octreotide and dietary intervention.
CONCLUSIONS: Chylous ascites should be included in differential diagnosis of abdominal distention after surgical retroperitoneal approach or radiotherapy. Most of the patients may have their chylous ascites successfully treated with conservative management. However, the best policy is to prevent chylous complications by employing meticulous dissection techniques and careful control of the major lymphatics by suture ligation during the primary surgical intervention.
METHODS: We report two cases of chylous fistula following systematic pelvic and retroperitoneal lymph node dissection for gynecological cancer without radiotherapy and review the literature.
RESULTS: Both were successfully managed with the maintenance of the postoperative drain, total parenteral nutrition, octreotide and dietary intervention.
CONCLUSIONS: Chylous ascites should be included in differential diagnosis of abdominal distention after surgical retroperitoneal approach or radiotherapy. Most of the patients may have their chylous ascites successfully treated with conservative management. However, the best policy is to prevent chylous complications by employing meticulous dissection techniques and careful control of the major lymphatics by suture ligation during the primary surgical intervention.