Postoperative chylous ascites after colorectal cancer surgery

Purpose To evaluate the diagnosis, epidemiology, risk factors, and treatment of chylous ascites after colorectal cancer surgery. Methods Among 907 patients who underwent colorectal cancer resection at our institution between 2006 and 2009, chylous ascites developed in 9. We analyzed the clinical data for these 9 patients. Results Five of the nine patients with chylous ascites had undergone right hemicolectomy and seven had undergone D3 lymph node dissection. In all patients, chylous ascites began to develop the day after commencement of oral intake or the next day. Two patients had no change in diet, one was started on a high-protein and low-fat diet, and six were put on intestinal fasting. Drainage tubes were removed within 5 days after treatment in seven patients. The hospital stay was about 2 weeks after surgery and 1 week after treatment. We found that the tumor area, tumors fed by the superior mesenteric artery, and D3 lymph node dissection were significantly associated with chylous ascites. Conclusions Chylous ascites after colorectal cancer surgery occurred at an incidence of 1.0%, but was significantly more frequent after surgery for tumors fed by the superior mesenteric artery and after D3 lymph node dissection. Conservative treatment was effective in all cases.