Enver Ilhan1, Uygar Demir1, Ali Alemdar1, Orhan Ureyen1, Yavuz Eryavuz1, Mehmet Mihmanli1. 1. 1 Department of General Surgery, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey ; 2 Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey ; 3 Department of General Surgery, Okmeydani Training and Research Hospital, Istanbul, Turkey.
Abstract
BACKGROUND: This study aimed to propose treatment strategies for high-output chylous ascites (CA) developed after gastric cancer surgery. METHODS: The data of patients with CA after gastric cancer surgery in three high volume Training and Research Hospitals between 2005 and 2015 were retrospectively evaluated. RESULTS: Nine patients out of 436 gastrectomies were detected with CA. The mean amount of daily fistula output was 939 mL. Treatment consisted of cessation of oral feeding, total parenteral nutrition (TPN), somatostatin analogs administration, clamping and/or removal of the drainage tube, diuretic administration and diet therapy with medium-chain triglycerides (MCTs) alone or in combination. The mean fistula closure time and length of hospital stay were 23 and 24 days respectively. Hemopneumothorax developed during right subclavian vein catheterisation for TPN implementation in one patient. There was no mortality. CONCLUSIONS: Combined cessation of oral feeding and TPN are usually used for treatment of CA as first-line treatment. However, TPN is no harmless. Although our data are limited they do allow us to conclude that diet with MCT's may use for medical treatment of CA as first-line.
BACKGROUND: This study aimed to propose treatment strategies for high-output chylous ascites (CA) developed after gastric cancer surgery. METHODS: The data of patients with CA after gastric cancer surgery in three high volume Training and Research Hospitals between 2005 and 2015 were retrospectively evaluated. RESULTS: Nine patients out of 436 gastrectomies were detected with CA. The mean amount of daily fistula output was 939 mL. Treatment consisted of cessation of oral feeding, total parenteral nutrition (TPN), somatostatin analogs administration, clamping and/or removal of the drainage tube, diuretic administration and diet therapy with medium-chain triglycerides (MCTs) alone or in combination. The mean fistula closure time and length of hospital stay were 23 and 24 days respectively. Hemopneumothorax developed during right subclavian vein catheterisation for TPN implementation in one patient. There was no mortality. CONCLUSIONS: Combined cessation of oral feeding and TPN are usually used for treatment of CA as first-line treatment. However, TPN is no harmless. Although our data are limited they do allow us to conclude that diet with MCT's may use for medical treatment of CA as first-line.
Authors: S Kuboki; H Shimizu; H Yoshidome; M Ohtsuka; A Kato; H Yoshitomi; K Furukawa; M Miyazaki Journal: Br J Surg Date: 2013-01-03 Impact factor: 6.939
Authors: Leandro Cardoso Barchi; Amir Zeide Charruf; Rodrigo José de Oliveira; Carlos Eduardo Jacob; Ivan Cecconello; Bruno Zilberstein Journal: Transl Gastroenterol Hepatol Date: 2016-12-27