title: Chylous ascites after laparoscopic lymph node dissection in gynecologic malignancies.
abstract: OBJECTIVE
  To evaluate the clinical presentation, epidemiology, risk factors, and treatment of chylous ascites after laparoscopic lymphadenectomy to treat gynecologic malignancies.
  
  
  METHODS
  Retrospective study with review of outcomes (Canadian Task Force classification II-3).
  
  
  METHODS
  University research hospital.
  
  
  METHODS
  From November 2009 to December 2012, 997 patients underwent laparoscopic lymphadenectomy to treat gynecologic malignancies at our hospital.
  
  
  METHODS
  Postoperative chylous ascites resolved with continuous drainage and dietary restriction or fasting.
  
  
  RESULTS
  Nine of 997 patients (0.9%) developed chylous ascites postoperatively. Mean age of these 9 patients was 47.5 years. Median time from operation to development of chylous ascites was 4 days (range, 2-9 days). Chylous ascites developed on either day 1 in 6 patients, day 2 in 2 patients, and day 8 in 1 patient, after food intake. We found that postoperative chylous ascites was associated more with para-aortic lymphadenectomy than with pelvic lymphadenectomy (overall incidence, 0.9%; 4.08% in the para-aortic lymphadenectomy group vs 0.35% in the pelvic lymphadenectomy group). In all patients, chylous ascites resolved with conservative treatment. Median time to resolution was 7 days (range, 3-9 days). Drainage tubes were removed within 9 days after treatment.
  
  
  CONCLUSIONS
  The incidence of chylous ascites after laparoscopic lymphadenectomy was 0.9%. Para-aortic lymphadenectomy was associated with postoperative chylous ascites. Chylous ascites was successfully treated with conservative management. An abdominal drainage tube can be a simple and effective approach and should be considered in the treatment of chylous ascites.
authors.affiliation: Department of Gynecology, Gynecologic and Obstetric Hospital, Fudan University, Shanghai, China.
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Gynecology, Gynecologic and Obstetric Hospital, Fudan University, Shanghai, China. Electronic address: dochwg@gmail.com.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Hu
authors.affiliation: Department of Gynecology, Gynecologic and Obstetric Hospital, Fudan University, Shanghai, China.
authors.forename: Xiaofan
authors.initials: X
authors.lastname: Hou
authors.affiliation: Department of Gynecology, Gynecologic and Obstetric Hospital, Fudan University, Shanghai, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhou
mesh_terms: D000328:Adult; D002915:Chylous Ascites / Q000209:etiology* / Q000628:therapy; D004322:Drainage; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008197:Lymph Node Excision / Q000009:adverse effects*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Chylous ascites; Drainage tube; Gynecologic malignancies; Laparoscopic lymphadenectomy; Management