Kong PF, Xu YH, Lai ZH, Ma MZ, Duan YT, Sun B, Xu DZ. Novel management indications for conservative treatment of chylous ascites after gastric cancer surgery. World J Gastroenterol 2022; 28(42): 6056-6067 [PMID: 36405388 DOI: 10.3748/wjg.v28.i42.6056]
Corresponding Author of This Article
Da-Zhi Xu, MD, PhD, Chief Doctor, Professor, Surgeon, Department of Gastric Surgery, Fudan University Shanghai Cancer Center, No. 270 Dong’an Road, Shanghai 200032, China. xudzh@shca.org.cn
Research Domain of This Article
Food Science & Technology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Peng-Fei Kong, Yong-Hu Xu, Ming-Zhe Ma, Yan-Tao Duan, Bo Sun, Da-Zhi Xu, Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
Zhi-Hua Lai, Department of the General Surgery, Suzhou Industrial Park Xinghai Hospital, Suzhou 215124, Jiangsu Province, China
Author contributions: Kong PF and Xu YH contributed equally to this work; Xu DZ designed the research study; Kong PF, Xu YH, Lai ZH and Sun B performed the research; Kong PF, Xu YH, Ma MZ and Duan YT analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by Ethics Committee of Fudan University Shanghai Cancer Center Review Board [Approval No. FUSCC-D-2021-164].
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Dataset available from the corresponding author at xudzh@shca.org.cn. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Da-Zhi Xu, MD, PhD, Chief Doctor, Professor, Surgeon, Department of Gastric Surgery, Fudan University Shanghai Cancer Center, No. 270 Dong’an Road, Shanghai 200032, China. xudzh@shca.org.cn
Received: June 27, 2022 Peer-review started: June 27, 2022 First decision: August 1, 2022 Revised: August 15, 2022 Accepted: October 26, 2022 Article in press: October 26, 2022 Published online: November 14, 2022
ARTICLE HIGHLIGHTS
Research background
Chylous ascites (CA) is relatively common postoperative complication in patients undergoing received gastric cancer (GC) surgery that obviously prolongs hospitalization and has a major impacts on subsequent adjuvant treatments.
Research motivation
Drainage tube (DT) clamping has been presented as a potential alternative conservative treatment for GC patients with CA.
Research objectives
This study aimed to explore key factors influencing CA treatment and recommend novel conservative treatment strategies for postoperative CA in GC patients.
Research methods
Data from patients with CA after GC surgery performed at the Fudan University Shanghai Cancer Center between 2006 and 2021 were retrospectively evaluated. Patients were classified into two distinct groups with respect to DT removal time. We further explored the differences in clinical-pathological features of the different DT removal groups.
Research results
Fifty-three patients underwent surgery for GC and experienced postoperative CA during the study period. Postoperative hospitalization and DT removal time showed a significant positive association (R2 = 0.979, P < 0.001), while delayed DT removal significantly extended total and postoperative hospitalization times, antibiotic usage duration, and hospitalization cost. In addition, postoperative infection and antibiotic usage were independent factors for delayed DT removal.
Research conclusions
Postoperative infection and antibiotic usage were vital independent factors that influenced delayed DT removal in GC patients with CA. Appropriate and lenient standards for DT removal may significantly reduce the duration of hospitalization.
Research perspectives
DT clamping could be recommended as an alternative for conservative treatment of postoperative CA.
