title: Chylous ascites and high-output chylous fistula after extended pelvic lymph node dissection for urological cancer: a rare postoperative complication.
abstract: OBJECTIVE
  Chylous ascites and high-output chylous fistula are rare complications following abdominal or pelvic surgery. We report a series of five cases that occurred after pelvic lymph node dissection for urological cancer, in addition to their clinical presentation, diagnosis, and treatment.
  
  
  METHODS
  The series comprises five patients; four men in whom robotic radical prostatectomy and extended pelvic lymphadenectomy were performed, and one woman with an infiltrating bladder cancer that underwent robotic anterior pelvic exenteration and extended pelvic lymphadenectomy. The first four patients developed chylous ascites, and the female patient a high-output chylous fistula.
  
  
  RESULTS
  In all cases, diagnosis of chylous ascites or chylous fistula was confirmed, and they were handled in varied ways, from observation to medical treatment, paracentesis, and surgery, according to their clinical presentation and evolution. We describe a simple treatment algorithm.
  
  
  CONCLUSIONS
  This rare surgical complication requires a grade of suspicion and a defined treatment according to the probability of the medical compromise. Prevention is an important element. This series, according to our knowledge, is the first description in patients undergoing robotic extended pelvic lymphadenectomy.
authors.affiliation: Departamento de Urología y Centro de Cirugía Robótica. Clínica INDISA.
authors.forename: Octavio A
authors.initials: OA
authors.lastname: Castillo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Borgna
mesh_terms: D002915:Chylous Ascites; D005260:Female; D005402:Fistula; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D011183:Postoperative Complications; D014571:Urologic Neoplasms