The number of
colorectal cancer (CRC) patients has been increasing rapidly worldwide in
recent decades. Curative resection is important, and major complications are
well reported, including surgical site infection, pneumonia, pulmonary
embolism, renal insufficiency, cerebrovascular accident and so on. Chylous ascites, a
rare problem after colorectal
cancer surgery, is defined as the extravasation of milky or creamy peritoneal
fluid rich in triglycerides. In this paper, the authors aimed to investigate
the epidemiology and risk factors of chylous ascites.
The authors
identified the cases of 913 consecutive patients who underwent surgery for
colorectal cancer at the University Hospital between January 2005 and December 2016.
The patients were 623 males and 390 females aged 28 -
90 years old (median 65 years old). The authors divided
the patients into two groups: Group A, having chylous ascites (n = 8), and
Group B, nonchylous ascites (n = 905). Then they compared the groups according
to these factors: age, gender, body mass index, tumor location, T, N factor,
stage, operation time, intra-operative bleeding, and duration of postoperative
hospital stay.
The results
demonstrated that neither age, sex, tumor location, and body mass index nor
number of lymph nodes were associated with postoperative chylous ascites.
Ascites occurred significantly less frequently in the early stage of colorectal
cancer than in the late stage (p = 0.04). There was no significant difference
between the groups in operative factors, including operation time and blood
loss. Postoperative hospital stays were longer in patients with chylous ascites
(20.5 days) than in those without (11 days) (p = 0.02).
In short, the present study showed that chylous ascites after laparoscopic
colon surgery required longer hospital stays but could be managed by
conservative treatment in all cases. And late stage was
one of the risk factors for chylous ascites in the present study. Other risks,
such as tumor location and blood loss, will vary from institution to
institution.
Article by Shinya
Munakata, et al, from Juntendo University, Tokyo, Japan.
Full access: http://mrw.so/5gfQLq
Image by newslanes newslanes, from
Flickr-cc.
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