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Preventing chylous ascites after right hemicolectomy with D3 extended mesenterectomy

Agustsdottir, Elin Edda Seland
Stroemmen, Tine Tveit
Sheikh, Ariba Ehsan
Elaiyarajah, Ilackiya
Lindstroem, Jonas Christoffer
Ignjatovic, Dejan
Published in Langenbeck's archives of surgery. 2020
Abstract Background We aim to find the incidence of chylous ascites in patients undergoing D3 extended mesenterectomy and evaluate if a routine fat-reduced diet (FRD) has a prophylactic effect. Methods Data from 138 patients included in a D3 extended mesenterectomy trial were collected prospectively. Surgical drains and biochemical testing of drain fluid were used to find the incidence of chylous ascites among the first 39 patients, and a prophylactic fat-reduced diet was then implemented in the next 99 patients as a prophylactic measure. Results In the first 39 patients, we found that 16 (41.0%) developed chylous ascites. After the fat-reduced diet was implemented, 1 (1.0%) of 99 patients developed chylous ascites. Drain discharge was 150 vs. 80 mL daily, respectively, and a regression analysis shows the average leakage in the group with fat-reduced diet was 105 mL/day less than in the patients with no dietary restrictions (p < 0.001). There were no significant differences in the rate of other complications (Fisher exact test, one-tailed p = 0.8845), and although there was a tendency to a shorter hospital stay when given a fat-reduced diet (7.3 ± 5.4 vs. 8.9 ± 4.9 days), the difference was not significant (p = 0.19). Conclusions Chylous ascites is a very common postoperative occurrence after right colectomy with extended D3 mesenterectomy and may be prevented using a routine fat-reduced diet.
Keywords Chylous ascitesD3 extended mesenterectomyFat-reduced dietFat-free dietLymphatic leak
PMID: 32691129
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AGUSTSDOTTIR, Elin Edda Seland et al. Preventing chylous ascites after right hemicolectomy with D3 extended mesenterectomy. In: Langenbeck's Archives of Surgery, 2020. doi: 10.1007/s00423-020-01938-4 https://archive-ouverte.unige.ch/unige:142480

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Deposited on : 2020-10-05

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