Clinical diagnosis and treatment of chyle leak after laparoscopic surgery for colorectal cancer
10.3781/j.issn.1000-7431.2023.2303-0095
- VernacularTitle:腹腔镜结直肠癌术后乳糜漏的临床诊治
- Author:
Shihao LI
1
;
Jun ZHOU
;
Ye WANG
;
Zheng LOU
Author Information
1. 海军军医大学第一附属医院,上海 200433
- Keywords:
Colorectal cancer;
Laproscopy;
Chyle Leak;
Prevention;
Clinical diagnosis and treatment
- From:
Tumor
2023;43(5):389-393
- CountryChina
- Language:Chinese
-
Abstract:
Chyle leak or chyle ascites is a specific form of lymphatic leakage after radical laparoscopic colorectal cancer surgery,the incidence of which has been reported in the literature to be 1％-6.5％,leading to the development of hydropower imbalance,malnutrition,impaired immune function,prolonged hospital stay and even an impact on oncological prognosis.Different surgical sites,number of lymph nodes dissected,duration of surgery,prognostic nutritional index,metastasis of the main lymph nodes,operator and age are risk factors for postoperative chyle leak in colorectal cancer.It usually occurs 4-8 days after surgery and is characterized by a sudden increase of drainage after eating which is milky,odourless and tasteless,and may be combined with abdominal pain,bloating and increased body temperature.After prolonged chyle leak,patients may develop water-electrolyte disturbance,malnutrition and hypoproteinemia.The chyle test is useful in the qualitative diagnosis of chyle leak and can be performed to detect triglyceride concentrations.Conservative treatment is the preferred treatment strategy for chyle leak,and if conservative treatment fails,surgery may be considered.Knowledge of the distribution pattern of colorectal lymphatic drainage and precise control of lymph node dissection are key measures to prevent chyle leak after laparoscopic colorectal cancer surgery.
