title: The conservative treatment of postoperative chylous ascites in gynecologic cancers: four case reports.
abstract: BACKGROUND
  Chylous ascites is a rare complication following radical surgery in gynecologic cancers. Its treatment is difficult due to nutritional and immunological problems caused by protein and lymphocyte loss. Its conservative treatment includes the use of a low-fat diet, medium chain triglyceride intake, paracentesis, total parenteral nutrition, and somatostatins. Other treatment options for resistant cases include surgical exploration and peritoneovenous shunt.
  
  
  METHODS
  We present four gynecologic cancer cases with development of chylous ascites following pelvic-para-aortic lymph dissection. Two of these cases were endometrial cancer, one was cervical cancer, and the last one was ovarian cancer. In three of these cases, chylous ascites developed immediately after surgery. In the cervical cancer case, it developed following surgery and radiotherapy. All subjects responded to conservative treatment.
  
  
  CONCLUSIONS
  Chylous ascites should be considered in the differential diagnosis of abdominal distension following retroperitoneal surgery. Cases generally respond well to conservative treatment. However, treatment options should be personalized, and the right treatment should be chosen for each patient. The best measure is to pay utmost attention to the ligation of large lymph vessels during lymph dissection.
authors.affiliation: Zekai Tahir Burak Women's Health Research and Education Hospital, Tunali Hilmi Cad. Binnaz Sok. No. 1/5 Kavaklidere, Ankara 06100, Turkey.
authors.forename: Turgut
authors.initials: T
authors.lastname: Var
authors.forename: Tayfun
authors.initials: T
authors.lastname: Güngor
authors.forename: Esra
authors.initials: E
authors.lastname: Tonguc
authors.forename: Tülin
authors.initials: T
authors.lastname: Ozdener
authors.forename: Leyla
authors.initials: L
authors.lastname: Mollamahmutoğlu
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D002915:Chylous Ascites / Q000209:etiology / Q000628:therapy*; D018752:Diet, Fat-Restricted; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000601:surgery*; D015282:Octreotide / Q000627:therapeutic use; D011183:Postoperative Complications / Q000628:therapy*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D015282:Octreotide