[Reoperation for refractory postoperative chylous ascites: value of peritoneovenous shunt combined with closure of lympho-peritoneal fistula].
Postoperative chylous ascites is a rare but serious complication resulting in denutrition, lymphopenia and infection. The first-intent treatment is usually conservative. We report a case of chylous ascites after retroperitoneal lymphadenectomy for testicular cancer, persisting despite conservative treatment then successfully treated by lymphostasis combined with peritoneovenous shunt. In case of high-output postoperative chylous ascites in low-risk patients with presumed localization of fistula, reoperation is indicated for lymphostasis. We advise to associate a peritoneovenous shunt in case of incomplete closure of the lymphoperitoneal fistula to avoid the morbidity of prolonged ascites.
Sledzianowski
J F
JF
Service de chirurgie digestive, hôpital Rangueil, 1, avenue J.-Poulhès, 31043 Toulouse, France.
Suc
B
B
Ferron
G
G
Fourtanier
G
G
D000328:Adult; D002915:Chylous Ascites / Q000601:surgery*; D005402:Fistula / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D008206:Lymphatic Diseases / Q000209:etiology / Q000601:surgery*; D008297:Male; D009919:Orchiectomy; D010532:Peritoneal Diseases / Q000209:etiology / Q000601:surgery*; D010536:Peritoneovenous Shunt; D011183:Postoperative Complications; D012086:Reoperation; D013724:Teratoma / Q000601:surgery; D013736:Testicular Neoplasms / Q000601:surgery; D013997:Time Factors