Lu J, Wei ZQ, Huang CM, Zheng CH, Li P, Xie JW, Wang JB, Lin JX, Chen QY, Cao LL, Lin M. Small-volume chylous ascites after laparoscopic radical gastrectomy for gastric cancer: Results from a large population-based sample. World J Gastroenterol 2015; 21(8): 2425-2432 [PMID: 25741151 DOI: 10.3748/wjg.v21.i8.2425]
Corresponding Author of This Article
Chang-Ming Huang, Professor, Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou 350001, Fujian Province, China. hcmlr2002@163.com
Research Domain of This Article
Gastroenterology & Hepatology
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/
World J Gastroenterol. Feb 28, 2015; 21(8): 2425-2432 Published online Feb 28, 2015. doi: 10.3748/wjg.v21.i8.2425
Table 1 Clinical manifestations of small-volume chylous ascites following laparoscopic radical gastrectomy
Symptom
n (%)
Abnormal blood leukocyte increase
54 (94.7)
Abdominal pain
40 (70.1)
Fever
20 (35.1)
Abdominal distension
19 (33.3)
Abdominal bleeding
2 (3.51)
Table 2 Comparison of the variables of patients with and without small-volume chylous ascites, according to a univariate analysis
Characteristic
SVCA (n = 57)
No SVCA (n = 1309)
P value
Gender
0.963
Male
43
991
Female
14
318
Age (yr)
63.60 ± 9.344
61.18 ± 11.346
0.091
Preoperative anemia
0.013
Present
26
395
Absent
31
914
Preoperative hypoproteinemia
0.012
Present
22
314
Absent
35
995
Tumor size (cm)
0.735
≥ 5
26
627
< 5
31
682
Tumor location
0.179
Upper
12
303
Middle
18
283
Lower
20
609
Diffuse
7
114
Histology
0.911
Differentiated
24
599
Undifferentiated
33
710
Tumor depth
0.690
T1
15
319
T2
6
147
T3
13
388
T4
23
455
Surgical management
0.481
Distal gastrectomy
28
603
Total gastrectomy
29
706
Lymph node status
0.004
N0
12
480
N1
9
195
N2
16
201
N3
20
433
Resected LNs (n)
35.12 ± 13.691
31.35 ± 11.494
0.045
Operative time (min)
201.12 ± 66.076
192.24 ± 84.062
0.430
Table 3 Correlation between small-volume chylous ascites and perigastric lymph nodes metastasis (n)
LADG
P value
LATG
P value
SVCA
No SVCA
SVCA
No SVCA
No. 1
0.969
0.314
+
1
31
5
138
-
18
581
33
559
No. 2
/
/
/
0.896
+
/
/
8
153
-
30
544
No. 3
0.948
0.115
+
7
221
18
420
-
12
391
20
277
No. 4
0.692
0.161
+
6
168
15
201
-
13
444
23
496
No. 5
0.458
0.093
+
4
91
1
79
-
15
521
37
618
No. 6
0.353
0.837
+
4
190
6
119
-
15
422
32
578
No. 7
0.431
0.505
+
1
67
9
200
-
18
545
29
497
No. 8
0.014
0.035
+
7
96
9
285
-
12
516
29
412
No. 9
0.017
0.000
+
6
78
32
240
-
13
534
6
457
No. 10
/
0.126
+
/
/
5
167
-
/
/
33
530
No. 11
0.898
0.134
+
2
59
5
165
-
17
553
33
532
No. 12a
0.579
0.182
+
15
450
21
459
-
4
162
17
238
Table 4 Multivariable analysis of the factors associated with the development of small-volume chylous ascites
Factor
P value
OR
95%CI
Resected LNs (n)
0.010
2.069
1.187
3.605
(≥ 32 vs < 32)
No. 8 metastasis
0.039
2.102
1.037
4.261
(positive vs negative)
No. 9 metastasis
0.000
4.019
2.011
8.030
(positive vs negative)
Preoperative anemia
0.486
1.247
0.67
2.321
(present vs absent)
Preoperative hypoproteinemia
0.076
0.566
0.302
1.062
(present vs absent)
N stage
0.000
N1 vs N0
0.053
1.519
0.688
7.426
N2 vs N0
0.000
5.194
2.244
12.021
N3 vs N0
0.000
7.342
2.774
19.431
Table 5 Comparison of postoperative recovery between the small-volume chylous ascites and non-small-volume chylous ascites groups
Factor
SVCA (n = 57)
No SVCA (n = 1309)
P value
Postoperative anal exhaust (d)
3.54 ± 1.283
3.54 ± 1.343
0.963
Postoperative food intake (d)
4.19 ± 2.326
4.62 ± 1.772
0.078
Postoperative hospital stay (d)
25.14 ± 15.693
13.11 ± 5.894
< 0.001
WBC count (POD1, × 109/L)
12.5 ± 3.8
13.1 ± 4.8
0.376
WBC count (POD3, × 109/L)
15.2 ± 2.4
12.2 ± 3.6
0.023
WBC count (POD5, × 109/L)
17.6 ± 4.7
11.6 ± 2.2
0.018
WBC count (POD7, × 109/L)
16.2 ± 5.8
10.9 ± 3.1
0.013
WBC count (discharge)
8.1 ± 1.5
7.3 ± 2.2
0.541
Citation: Lu J, Wei ZQ, Huang CM, Zheng CH, Li P, Xie JW, Wang JB, Lin JX, Chen QY, Cao LL, Lin M. Small-volume chylous ascites after laparoscopic radical gastrectomy for gastric cancer: Results from a large population-based sample. World J Gastroenterol 2015; 21(8): 2425-2432