Department of Obstetrics and Gynecology, New York Presbyterian Hospital-Cornell University Medical Center, New York, NY 10065, USA.
Gynecol Oncol. 2012 Apr;125(1):48-53. doi: 10.1016/j.ygyno.2011.11.012. Epub 2011 Nov 18.
Lymphatic ascites is an unusual complication in patients with cancer. In the gynecologic oncology patient population, the most common etiology is operative lymph node dissection. The purpose of this study was to explore the incidence, presenting symptoms, methods of diagnosis and treatment modalities utilized for lymphatic ascites in patients undergoing lymph node dissection for gynecologic cancers.
This observational study retrospectively reviewed the charts of patients who underwent lymphadenectomy as part of the surgical management for a gynecologic cancer. Patients that developed postoperative lymphatic ascites between January 2000 and December 2010 were included for analysis. Data extracted from the medical records included tumor pathology, number of harvested lymph nodes, postoperative course, method of diagnosis and treatment.
From a total of 300 surgical staging procedures, 12 patients with lymphatic ascites were identified (4%). The most common reported symptom was leakage of clear fluid per vagina (7, 58%), followed by abdominal distension (4, 33%). The median interval from surgery to development of symptoms was 12.5 days (range 0-22 days). 5 patients had complete resolution of symptoms with dietary modifications alone while 7 patients required paracentesis. The median time from surgery to resolution of symptoms was 44 days (range 9-99).
Lymphatic ascites is an under recognized and infrequently reported postoperative complication. Although it usually resolves spontaneously or with conservative management without sequelae, this condition can significantly prolong postoperative recovery and cause patient discomfort. To our knowledge this is the largest group of patients undergoing gynecologic surgical staging procedures to be reviewed for the occurrence of lymphatic ascites.
淋巴腹水是癌症患者的一种罕见并发症。在妇科肿瘤患者中，最常见的病因是手术性淋巴结清扫术。本研究旨在探讨妇科癌症患者行淋巴结清扫术后发生淋巴腹水的发生率、临床表现、诊断方法和治疗方式。
本观察性研究回顾性分析了 2000 年 1 月至 2010 年 12 月期间因妇科癌症接受淋巴结切除术的患者的病历。纳入分析术后发生淋巴腹水的患者。从病历中提取的数据包括肿瘤病理、采集的淋巴结数量、术后过程、诊断和治疗方法。
在总共 300 例手术分期手术中，发现 12 例（4%）患者发生淋巴腹水。最常见的报告症状是阴道漏出清亮液体（7 例，58%），其次是腹胀（4 例，33%）。从手术到出现症状的中位间隔时间为 12.5 天（范围 0-22 天）。5 例患者仅通过饮食改变即可完全缓解症状，而 7 例患者需要进行腹腔穿刺术。从手术到症状缓解的中位时间为 44 天（范围 9-99 天）。
淋巴腹水是一种认识不足且罕见报告的术后并发症。尽管它通常可以自行缓解或通过保守治疗而无后遗症，但这种情况会显著延长术后恢复时间并引起患者不适。据我们所知，这是最大的一组接受妇科手术分期手术的患者，以评估淋巴腹水的发生情况。
