Chylous ascites in colorectal surgery:A systematic review

作     者：Zi Qin Ng Margaret Han Han Nien Beh Simon Keelan 

作者机构：Department of General SurgerySt John of God Midland HospitalMidland 6056Western AustraliaAustralia Department of General SurgeryJoondalup Health CampusJoondalup 6027Western AustraliaAustralia 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2021年第13卷第6期

页      面：585-596页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Chylous Chyle Ascites Leak Colon Rectum Lymphadenectomy 

摘      要：BACKGROUND Chylous ascites is a rare complication in colorectal surgery with limited *** To systematically review all available evidence to describe the incidence,clinical presentation,risk factors and management *** The systematic review was performed through PubMed,MEDLINE,EMBASE and Cochrane and cross-checked up to November *** data collated included:Demographics,indications(benign vs malignant),site of disease,surgical approach,extent of lymphadenectomy,day to and method of diagnosis of chylous ascites and management *** A total of 28 studies were included in the final analysis(426 cases).Patient age ranged from 31 to 89 *** except one case were performed for *** the 426 cases,195 were right-colonic,121 left-colonic,103 pelvic surgeries and 7 *** majority were diagnosed during the same inpatient stay by recognition of typical drain appearance and increased *** cases were diagnosed during outpatient visits with increased abdominal distention and subsequently underwent *** cases were managed successfully non-operatively(fasting with prolonged drainage,total parenteral nutrition,somatostatin analogues or a combination of these).Only three cases required surgical intervention after failing conservative management and subsequently resolved *** factors identified include:Right-colonic surgery/tumour location,extent of lymphadenectomy and number of lymph nodes *** Chylous ascites after colorectal surgery is a relatively rare *** the majority of cases resolved without surgical intervention,preventative measures should be undertaken such as meticulous dissection and clipping of lymphatics during lymphadenectomy to prevent morbidity.