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Impact of Chylous Ascites on Colon Cancer in Laparoscopic Surgery

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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