Division of Colorectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Inchon-ro 73, Seongbuk-gu, Seoul 136-705, Korea.
Am J Surg. 2013 Oct;206(4):555-9. doi: 10.1016/j.amjsurg.2013.01.033. Epub 2013 Jul 12.
The aim of this study was to identify possible risk factors associated with chylous ascites after colorectal cancer surgery.
Patients who underwent colorectal cancer resection were enrolled in this study. Data were compared between patients who developed chylous ascites and those who did not.
Chylous ascites was detected in 48 (6.6%) patients. There were significant differences between the groups with and without chylous ascites in terms of age (65.6 vs 61.6 years, P = .017), operator (5.0% vs 15.5%, P < .001), operative procedure based on tumor location (P = .041), operative time (206.0 vs 229.8 minutes, P = .045), and blood loss (78.1 vs 219.7 mL, P = .036). After subgroup analysis for right-sided colectomy and low anterior resection to compensate for the effects of the operative procedure, the differences in the operative time and blood loss were not significant. In most patients, chylous ascites was resolved with conservative management.
Chylous ascites developed significantly more frequently in patients who underwent right-sided colectomy and in elderly patients. In addition, the incidence was also dependent on the operator. Conservative treatment was effective in most patients.
本研究旨在确定与结直肠癌手术后乳糜性腹水相关的可能危险因素。
本研究纳入了接受结直肠癌切除术的患者。比较了发生乳糜性腹水和未发生乳糜性腹水的患者之间的数据。
48 例(6.6%)患者出现乳糜性腹水。在年龄(65.6 岁 vs 61.6 岁,P =.017)、术者(5.0% vs 15.5%,P <.001)、基于肿瘤位置的手术方式(P =.041)、手术时间(206.0 分钟 vs 229.8 分钟,P =.045)和出血量(78.1 毫升 vs 219.7 毫升,P =.036)方面,有乳糜性腹水的患者和无乳糜性腹水的患者之间存在显著差异。对右半结肠切除术和低位前切除术进行亚组分析以补偿手术方式的影响后,手术时间和出血量的差异无统计学意义。大多数患者经保守治疗后乳糜性腹水得到缓解。
右半结肠切除术和老年患者发生乳糜性腹水的风险显著增加。此外,发生率还取决于术者。大多数患者的保守治疗有效。