title: Chyle leak following surgery for abdominal neuroblastoma.
abstract: BACKGROUND
  The incidence and optimal management of postoperative chylous leak of neuroblastoma is inadequately documented. We analyzed the risk factors, management, and the implication of chyle leak following surgery for abdominal neuroblastoma.
  
  
  METHODS
  One hundred sixty patients who underwent surgery for abdominal neuroblastoma between September 2004 and August 2014 were evaluated. To find the oncological implication we evaluated the delay in starting further treatment, local control, event free and overall survival.
  
  
  RESULTS
  Chyle leak was the most common complication (20%). The median measure of leakage was 100ml/day and it persisted for a median of 12days. All patients were managed conservatively except one who needed exploration for wound dehiscence. Number of lymph nodes resected was the only factor associated with the risk of chyle leaks (p=0.013). Adjuvant chemotherapy was not delayed in any patient because of chyle leaks per se and the local control, event free and overall survival were not different for patients with and without chyle leak.
  
  
  CONCLUSIONS
  Chylous leakage is a common postoperative complication of abdominal neuroblastoma, predisposed by the number of lymph nodes resected. It responds to conservative management and does not compromise further the oncological treatment and outcome hence; it should not be a deterrent to complete surgery.
authors.affiliation: Division of Pediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Centre, Bombay, India. Electronic address: sajidshafiques@hotmail.com.
authors.forename: Sajid S
authors.initials: SS
authors.lastname: Qureshi
authors.affiliation: Division of Pediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Centre, Bombay, India.
authors.forename: Eugene G
authors.initials: EG
authors.lastname: Rent
authors.affiliation: Division of Pediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Centre, Bombay, India.
authors.forename: Monica
authors.initials: M
authors.lastname: Bhagat
authors.affiliation: Tata Institute of Social Science, Bombay, India.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Dsouza
authors.affiliation: Department of Radiology, Tata Memorial Centre, Bombay, India.
authors.forename: Seema
authors.initials: S
authors.lastname: Kembhavi
authors.affiliation: Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Centre, Bombay, India.
authors.forename: Tushar
authors.initials: T
authors.lastname: Vora
authors.affiliation: Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Centre, Bombay, India.
authors.forename: Maya
authors.initials: M
authors.lastname: Prasad
authors.affiliation: Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Centre, Bombay, India.
authors.forename: Girish
authors.initials: G
authors.lastname: Chinnaswamy
authors.affiliation: Department of Pathology, Tata Memorial Centre, Bombay, India.
authors.forename: Mukta
authors.initials: M
authors.lastname: Ramadwar
authors.affiliation: Department of Radiation Oncology, Tata Memorial Centre, Bombay, India.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Laskar
authors.affiliation: Department of Radiation Oncology, Tata Memorial Centre, Bombay, India.
authors.forename: Nehal
authors.initials: N
authors.lastname: Khanna
authors.affiliation: Department of Nuclear Medicine, Tata Memorial Centre, Bombay, India.
authors.forename: Sneha
authors.initials: S
authors.lastname: Shah
authors.affiliation: Department of Biostatistics, Tata Memorial Centre, Bombay, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Talole
mesh_terms: D000005:Abdomen; D000008:Abdominal Neoplasms / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002913:Chyle; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008197:Lymph Node Excision; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D008297:Male; D009447:Neuroblastoma / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Abdominal surgery; Chyle leak; Conservative treatment; Neuroblastoma