Chylous Ascites After Gastric Cancer Surgery: Risk Factors and Treatment Results.

IF 3.2 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Sung Hyun Park, Ki-Yoon Kim, Minah Cho, Hyoung-Il Kim, Woo Jin Hyung, Yoo Min Kim
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Abstract

Purpose: Although chylous ascites is a frequent complication of radical gastrectomy for gastric cancer, proper diagnostic criteria and optimal treatment strategies have not been established. This study aimed to identify the clinical features of chylous ascites and evaluate the treatment outcomes.

Materials and methods: We retrospectively analyzed the data of patients who underwent radical gastrectomy between 2013 and 2019. Diagnosis was made when milky fluid or elevated triglyceride levels (≥100 mg/dL) appeared in the drains without a preceding infection. The clinical features, risk factors, and treatment outcomes were assessed according to the initial treatment modalities for fasting and non-fasting groups.

Results: Among the 7,388 patients who underwent radical gastrectomy for gastric cancer, 156 (2.1%) experienced chylous ascites. The median length of hospital stay was longer in patients with chylous ascites than in those without (median [interquartile range]: 8.0 [6.0-12.0] vs. 6.0 [5.0-8.0], P<0.001). Low body mass index (adjusted odds ratio [aOR]=0.9; P<0.001), advanced gastric cancer (aOR=1.51, P=0.024), open surgery (reference: laparoscopic surgery; aOR=1.87, P=0.003), and extent of surgical resection (reference: subtotal gastrectomy, total gastrectomy, aOR=1.5, P=0.029; proximal gastrectomy, aOR=2.93, P=0.002) were associated with the occurrence of chylous ascites. The fasting group (n=12) was hospitalized for a longer period than the non-fasting group (n=144) (15.0 [12.5-19.5] vs. 8.0 [6.0-10.0], P<0.001). There was no difference in grade III complication rate (16.7% vs. 4.2%, P=0.117) or readmission rate (16.7% vs. 11.1%, P=0.632) between the groups.

Conclusions: A fat-controlled diet and medication without fasting provided adequate initial treatment for chylous ascites after radical gastrectomy for gastric cancer.

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胃癌术后乳糜腹水:危险因素及治疗效果。
目的:虽然乳糜腹水是胃癌根治术的常见并发症,但尚未建立正确的诊断标准和最佳治疗策略。本研究旨在探讨乳糜腹水的临床特点及治疗效果。材料和方法:回顾性分析2013年至2019年接受根治性胃切除术的患者资料。诊断时,乳白色液体或甘油三酯水平升高(≥100mg /dL)出现在下水道,没有先前的感染。根据禁食组和非禁食组的初始治疗方式评估临床特征、危险因素和治疗结果。结果:7388例胃癌根治术患者中,156例(2.1%)发生乳糜腹水。乳糜腹水患者的中位住院时间比无乳糜腹水患者的中位住院时间更长(中位数[四分位数范围]:8.0 [6.0-12.0]vs. 6.0[5.0-8.0])。结论:控制脂肪饮食和不禁食的药物治疗为胃癌根治性胃切除术后乳糜腹水提供了足够的初始治疗。
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来源期刊
Journal of Gastric Cancer
Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
4.30
自引率
12.00%
发文量
36
期刊介绍: The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.
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