Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2021; 13(11): 1361-1371
Published online Nov 27, 2021. doi: 10.4240/wjgs.v13.i11.1361
Nomogram for predicting chylous ascites after right colectomy
Hui-Da Zheng, Yu-Rong Liu, Zhen-Ze Chen, Ya-Feng Sun, Chun-Hao Xu, Jian-Hua Xu
Hui-Da Zheng, Yu-Rong Liu, Zhen-Ze Chen, Ya-Feng Sun, Chun-Hao Xu, Jian-Hua Xu, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
Author contributions: Zheng HD collected the clinical data and prepared the manuscript; Zheng HD, Liu YR, Chen ZZ, and Xu CH designed the study and supervised the statistical data; Zheng HD and Sun YF contributed to the analyses; Xu JH provided clinical advice, reviewed the manuscript and gave final approval of the version of the article to be published.
Supported by Malignant Tumor Clinical Medicine Research Center, Quanzhou City, Fujian Province, China, No. 2020N090s.
Institutional review board statement: This study was approved by the Ethics Committee of the Second Affiliated Hospital of Fujian Medical University (approval No. 2021-0227).
Informed consent statement: The requirement for informed consent was waived by the Ethics Committee considering the retrospective design of the study.
Conflict-of-interest statement: All authors report no conflicts of interest.
Data sharing statement: No additional data was available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Hua Xu, MD, Chief Doctor, Dean, Professor, Research Dean, Surgeon, Surgical Oncologist, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, No. 950 Donghai Street, Fengze District, Quanzhou 362000, Fujian Province, China. xjh630913@126.com
Received: June 8, 2021
Peer-review started: June 8, 2021
First decision: June 30, 2021
Revised: July 1, 2021
Accepted: September 15, 2021
Article in press: September 15, 2021
Published online: November 27, 2021
Processing time: 171 Days and 4.2 Hours
Abstract
BACKGROUND

Chylous ascites following right colectomy has a high incidence which is a critical challenge. At present, there are few studies on the factors affecting chylous ascites after right colectomy and especially after D3 Lymphadenectomy. A predictive model for chylous ascites has not yet been established. Therefore, we created the first nomogram to predict the incidence of chylous ascites after right hemicolectomy.

AIM

To analyze the risk factors for chylous ascites after right colectomy and establish a nomogram to predict the incidence of chylous ascites.

METHODS

We retrospectively collected patients who underwent right hemicolectomy between January 2012 and May 2021 and were pathologically diagnosed with cancer. Multivariate logistic regression was used to analyze the influencing factors of chylous ascites and a nomogram was established. The predictive ability was assessed by the area under the receiver operating characteristic (ROC) curve.

RESULTS

Operative time, the type of operation (standard or extended), the number of lymph nodes retrieved, and somatostatin administration were considered important risk factors. Multivariate logistic regression and nomograms can be used to accurately predict whether chylous ascites occurs. The area under the ROC curve of the model is 0.770. The C-statistic of this model is 0.770 which indicates that it has a relatively moderate ability to predict the risk of chylous ascites.

CONCLUSION

We found a novel set of risk factors, created a nomogram, and validated it. The nomogram had a relatively accurate forecasting ability for chylous ascites after right hemicolectomy and can be used as a reference for risk assessment of chylous ascites and whether to prevent it after surgery.

Keywords: Nomogram; Right colectomy; Chylous ascites; Risk factors

Core Tip: The article retrospectively analyzed the incidence of chylous ascites after right colectomy, and through multivariate analysis, the operative time, the type of operation (standard or extended), and the number of lymph nodes retrieved were identified as risk factors, while the administration of somatostatin or synthetic analogs after surgery was a protective factor. Based on these factors, we created a nomogram with moderate ability to predict the risk of chylous ascites.