BACKGROUND Chylous ascites is a rare complication in colorectal surgery with limited evidence.AIM To systematically review all available evidence to describe the incidence,clinical presentation,risk factors and manage...BACKGROUND Chylous ascites is a rare complication in colorectal surgery with limited evidence.AIM To systematically review all available evidence to describe the incidence,clinical presentation,risk factors and management strategies.METHODS The systematic review was performed through PubMed,MEDLINE,EMBASE and Cochrane and cross-checked up to November 2020.The data collated included:Demographics,indications(benign vs malignant),site of disease,surgical approach,extent of lymphadenectomy,day to and method of diagnosis of chylous ascites and management strategies.RESULTS A total of 28 studies were included in the final analysis(426 cases).Patient age ranged from 31 to 89 years.All except one case were performed for malignancy.Of the 426 cases,195 were right-colonic,121 left-colonic,103 pelvic surgeries and 7 others.The majority were diagnosed during the same inpatient stay by recognition of typical drain appearance and increased volume.Three cases were diagnosed during outpatient visits with increased abdominal distention and subsequently underwent paracentesis.Most cases were managed successfully non-operatively(fasting with prolonged drainage,total parenteral nutrition,somatostatin analogues or a combination of these).Only three cases required surgical intervention after failing conservative management and subsequently resolved completely.Risk factors identified include:Right-colonic surgery/tumour location,extent of lymphadenectomy and number of lymph nodes harvested.CONCLUSION Chylous ascites after colorectal surgery is a relatively rare complication.Whilst the majority of cases resolved without surgical intervention,preventative measures should be undertaken such as meticulous dissection and clipping of lymphatics during lymphadenectomy to prevent morbidity.展开更多
Acute abdominal pain with signs and symptoms of peritonitis due to sudden extravasation of chyle into the peritoneal cavity is a rare condition that is often mistaken for other disease processes. The diagnosis is rare...Acute abdominal pain with signs and symptoms of peritonitis due to sudden extravasation of chyle into the peritoneal cavity is a rare condition that is often mistaken for other disease processes. The diagnosis is rarely suspected preoperatively. We report a case of spontaneous chylous peritonitis that presented with typical symptoms of acute appendicitis such as intermittent fever and epigastric pain radiating to the lower right abdominal quadrant before admission.展开更多
Aim:We investigated the clinical application of autologous chyle fat in the correction of sunken upper eyelid.Methods:From November 2020 to October 2021,89 cases of correction with autologous chyle fat to sunken upper...Aim:We investigated the clinical application of autologous chyle fat in the correction of sunken upper eyelid.Methods:From November 2020 to October 2021,89 cases of correction with autologous chyle fat to sunken upper eyelid were performed(with or without other cosmetic procedures related to the eyes).An appropriate amount of fat was extracted from the superficial layer of the patient’s thigh and processed to chyle fat.About 0.5-2.8 mL of fat was injected under the orbicularis oculi muscle(roof-retro orbicularis oculi fat)or in the area where the orbital septal fat exists from the outer orbital margin of the upper eyelid.Results:In total,59 patients were followed up for 1-11 months after surgery.No infection,necrosis,vascular embolism,upper eyelid lumpiness,fat calcification,or liquefaction occurred in all patients,while seven cases showed inadequate correction.The depression basically disappeared,the shape was relatively full,the youthfulness was greatly improved,and the satisfaction of patients was high during the follow-up period.Conclusion:The correction with autologous chyle fat to sunken upper eyelid showed little trauma,short recovery periods,and satisfactory results,and it is worthy of being popularized and applied more widely.展开更多
文摘BACKGROUND Chylous ascites is a rare complication in colorectal surgery with limited evidence.AIM To systematically review all available evidence to describe the incidence,clinical presentation,risk factors and management strategies.METHODS The systematic review was performed through PubMed,MEDLINE,EMBASE and Cochrane and cross-checked up to November 2020.The data collated included:Demographics,indications(benign vs malignant),site of disease,surgical approach,extent of lymphadenectomy,day to and method of diagnosis of chylous ascites and management strategies.RESULTS A total of 28 studies were included in the final analysis(426 cases).Patient age ranged from 31 to 89 years.All except one case were performed for malignancy.Of the 426 cases,195 were right-colonic,121 left-colonic,103 pelvic surgeries and 7 others.The majority were diagnosed during the same inpatient stay by recognition of typical drain appearance and increased volume.Three cases were diagnosed during outpatient visits with increased abdominal distention and subsequently underwent paracentesis.Most cases were managed successfully non-operatively(fasting with prolonged drainage,total parenteral nutrition,somatostatin analogues or a combination of these).Only three cases required surgical intervention after failing conservative management and subsequently resolved completely.Risk factors identified include:Right-colonic surgery/tumour location,extent of lymphadenectomy and number of lymph nodes harvested.CONCLUSION Chylous ascites after colorectal surgery is a relatively rare complication.Whilst the majority of cases resolved without surgical intervention,preventative measures should be undertaken such as meticulous dissection and clipping of lymphatics during lymphadenectomy to prevent morbidity.
基金Supported by the National Natural Science Foundation of China,No.30224801
文摘Acute abdominal pain with signs and symptoms of peritonitis due to sudden extravasation of chyle into the peritoneal cavity is a rare condition that is often mistaken for other disease processes. The diagnosis is rarely suspected preoperatively. We report a case of spontaneous chylous peritonitis that presented with typical symptoms of acute appendicitis such as intermittent fever and epigastric pain radiating to the lower right abdominal quadrant before admission.
文摘Aim:We investigated the clinical application of autologous chyle fat in the correction of sunken upper eyelid.Methods:From November 2020 to October 2021,89 cases of correction with autologous chyle fat to sunken upper eyelid were performed(with or without other cosmetic procedures related to the eyes).An appropriate amount of fat was extracted from the superficial layer of the patient’s thigh and processed to chyle fat.About 0.5-2.8 mL of fat was injected under the orbicularis oculi muscle(roof-retro orbicularis oculi fat)or in the area where the orbital septal fat exists from the outer orbital margin of the upper eyelid.Results:In total,59 patients were followed up for 1-11 months after surgery.No infection,necrosis,vascular embolism,upper eyelid lumpiness,fat calcification,or liquefaction occurred in all patients,while seven cases showed inadequate correction.The depression basically disappeared,the shape was relatively full,the youthfulness was greatly improved,and the satisfaction of patients was high during the follow-up period.Conclusion:The correction with autologous chyle fat to sunken upper eyelid showed little trauma,short recovery periods,and satisfactory results,and it is worthy of being popularized and applied more widely.
