Sajid S Qureshi1, Eugene G Rent2, Monica Bhagat2, Priyanka Dsouza3, Seema Kembhavi4, Tushar Vora5, Maya Prasad5, Girish Chinnaswamy5, Mukta Ramadwar6, Siddharth Laskar7, Nehal Khanna7, Sneha Shah8, Sanjay Talole9. 1. Division of Pediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Centre, Bombay, India. Electronic address: sajidshafiques@hotmail.com. 2. Division of Pediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Centre, Bombay, India. 3. Tata Institute of Social Science, Bombay, India. 4. Department of Radiology, Tata Memorial Centre, Bombay, India. 5. Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Centre, Bombay, India. 6. Department of Pathology, Tata Memorial Centre, Bombay, India. 7. Department of Radiation Oncology, Tata Memorial Centre, Bombay, India. 8. Department of Nuclear Medicine, Tata Memorial Centre, Bombay, India. 9. Department of Biostatistics, Tata Memorial Centre, Bombay, India.
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. CONCLUSION: 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.
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. CONCLUSION: 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: Simone de Campos Vieira Abib; Chan Hon Chui; Sharon Cox; Abdelhafeez H Abdelhafeez; Israel Fernandez-Pineda; Ahmed Elgendy; Jonathan Karpelowsky; Pablo Lobos; Marc Wijnen; Jörg Fuchs; Andrea Hayes; Justin T Gerstle Journal: Ecancermedicalscience Date: 2022-02-17