J Gynecol Oncol.  2011 Mar;22(1):61-63. 10.3802/jgo.2011.22.1.61.

Chylous ascites following robotic lymph node dissection on a patient with metastatic cervical carcinoma

• Soto E
• Soto C
• Nezhat FR
• Gretz HF
• Chuang L

• KMID: 2173589
• DOI: http://doi.org/10.3802/jgo.2011.22.1.61

Abstract

Chylous ascites is an uncommon postoperative complication of gynecological surgery. We report a case of chylous ascites following a robotic lymph node dissection for a cervical carcinoma. A 38-year-old woman with IB2 cervical adenocarcinoma with a palpable 3 cm left external iliac lymph node was taken to the operating room for robotic-assisted laparoscopic pelvic and para-aortic lymph node dissection. Patient was discharged on postoperative day 2 after an apparent uncomplicated procedure. The patient was readmitted the hospital on postoperative day 9 with abdominal distention and a CT-scan revealed free fluid in the abdomen and pelvis. A paracentesis demonstrated milky-fluid with an elevated concentration of triglycerides, confirming the diagnosis of chylous ascites. She recovered well with conservative measures. The risk of postoperative chylous ascites following lymph node dissection is still present despite the utilization of new technologies such as the da Vinci robot.

Keyword

Chylous ascites; Robotic surgery; Cervical carcinoma

MeSH Terms

Abdomen
Adenocarcinoma
Adult
Chylous Ascites
Female
Gynecologic Surgical Procedures
Humans
Lymph Node Excision
Lymph Nodes
Operating Rooms
Paracentesis
Pelvis
Postoperative Complications
Triglycerides
Triglycerides

Figure

• 

  Fig. 1 CT scan demonstrated abdominal ascites. Hemoclips were noted on the previous left iliac lymphadenectomy site.

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