Small-volume chylous ascites after laparoscopic radical gastrectomy for gastric cancer: results from a large population-based sample

World J Gastroenterol. 2015 Feb 28;21(8):2425-32. doi: 10.3748/wjg.v21.i8.2425.

Abstract

Aim: To report the incidence and potential risk factors of small-volume chylous ascites (SVCA) following laparoscopic radical gastrectomy (LAG).

Methods: A total of 1366 consecutive gastric cancer patients who underwent LAG from January 2008 to June 2011 were enrolled in this study. We analyzed the patients based on the presence or absence of SVCA.

Results: SVCA was detected in 57 (4.17%) patients, as determined by the small-volume drainage (range, 30-100 mL/24 h) of triglyceride-rich fluid. Both univariate and multivariate analyses revealed that the total number of resected lymph nodes (LNs), No. 8 or No. 9 LN metastasis and N stage were independent risk factors for SVCA following LAG (P<0.05). Regarding hospital stay, there was a significant difference between the groups with and without SVCA (P<0.001). The 3-year disease-free and overall survival rates of the patients with SVCA were 47.4% and 56.1%, respectively, which were similar to those of the patients without SVCA (P>0.05).

Conclusion: SVCA following LAG developed significantly more frequently in the patients with ≥32 harvested LNs, ≥3 metastatic LNs, or No. 8 or No. 9 LN metastasis. SVCA, which was successfully treated with conservative management, was associated with a prolonged hospital stay but was not associated with the prognosis.

Keywords: Chylous ascites; Gastric cancer; Laparoscopic gastrectomy; Small volume.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chi-Square Distribution
  • Child
  • China / epidemiology
  • Chylous Ascites / diagnosis
  • Chylous Ascites / epidemiology*
  • Databases, Factual
  • Disease-Free Survival
  • Female
  • Gastrectomy / adverse effects*
  • Gastrectomy / methods
  • Gastrectomy / mortality
  • Humans
  • Incidence
  • Kaplan-Meier Estimate
  • Laparoscopy / adverse effects*
  • Laparoscopy / methods
  • Laparoscopy / mortality
  • Length of Stay
  • Logistic Models
  • Lymph Node Excision / adverse effects
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Retrospective Studies
  • Risk Factors
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Time Factors
  • Treatment Outcome
  • Young Adult