Ng ZQ, Han M, Beh HN, Keelan S. Chylous ascites in colorectal surgery: A systematic review. World J Gastrointest Surg 2021; 13(6): 585-596 [PMID: 34194616 DOI: 10.4240/wjgs.v13.i6.585]
Corresponding Author of This Article
Zi Qin Ng, MBBS, Department of General Surgery, St John of God Midland Hospital, 1 Clayton Street, Midland 6056, Western Australia, Australia. kentng@hotmail.co.uk
Research Domain of This Article
Surgery
Article-Type of This Article
Systematic Reviews
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 Gastrointest Surg. Jun 27, 2021; 13(6): 585-596 Published online Jun 27, 2021. doi: 10.4240/wjgs.v13.i6.585
Chylous ascites in colorectal surgery: A systematic review
Zi Qin Ng, Margaret Han, Han Nien Beh, Simon Keelan
Zi Qin Ng, Department of General Surgery, St John of God Midland Hospital, Midland 6056, Western Australia, Australia
Zi Qin Ng, Margaret Han, Han Nien Beh, Simon Keelan, Department of General Surgery, Joondalup Health Campus, Joondalup 6027, Western Australia, Australia
Author contributions: Ng ZQ was responsible for study design, collected and analyzed data, drafted the manuscript; Han M collected and analyzed data and review of manuscript; Beh HN were responsible for date analysis and review of the manuscript; Keelan S was responsible for co-design study, data analysis and critical review of the manuscript; all authors approved the final version of the manuscript to be submitted.
Conflict-of-interest statement: The authors have no conflict of interest or financial ties to disclose.
PRISMA 2009 Checklist statement: The authors confirm that the manuscript was prepared according to the PRISMA 2009 checklist.
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: Zi Qin Ng, MBBS, Department of General Surgery, St John of God Midland Hospital, 1 Clayton Street, Midland 6056, Western Australia, Australia. kentng@hotmail.co.uk
Received: January 18, 2021 Peer-review started: January 18, 2021 First decision: April 19, 2021 Revised: April 24, 2021 Accepted: May 19, 2021 Article in press: May 19, 2021 Published online: June 27, 2021 Processing time: 150 Days and 23.7 Hours
ARTICLE HIGHLIGHTS
Research background
Chylous ascites or chyle leak after colorectal surgery remains a relatively rare complication.
Research motivation
There has been an increase in the uptake of complete mesocolic resection (CME) or D3 lymphadenectomy in colorectal surgery. As a result, it is thought that this is an important risk factor for chylous ascites or chyle leak.
Research objectives
The aim of this study was to perform a systematic review on all evidence on chylous ascites or chyle leak after colorectal surgery to describe its incidence, clinical presentation, risk factors and management options.
Research methods
A systematic review of the literature was performed by searching PubMed, MEDLINE, EMBASE and Cochrane databases up to November 2020.
Research results
From 2000 to 2010, 59 cases of chylous ascites or chyle leak were reported. Between 2011 to 2020, there was a six-fold increase in number of cases reported. The estimated incidence of chylous ascites or chyle leak after colorectal surgery from these series is 5.5%.
Research conclusions
Chylous ascites or chyle leak after colorectal surgery is a rare complication especially in the Western world. Whilst the majority of cases resolve with conservative management, meticulous dissection and clipping of lymphatics especially during extended lymphadenectomy are vital to prevent this complication and its associated morbidity.
Research perspectives
Future colorectal trials should include this as a reported complication given the increasing number of CME and D3 Lymphadenectomy.
