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Title: Case of the month from University of Melbourne, Australia: refractory chyle leak after retroperitoneal lymph node dissection with updated algorithm.
Epworth Authors: Lawrentschuk, Nathan
Other Authors: Homewood, David
O'Brien, Jonathan
Manning, Todd
Kelly, Brian
Chan, Phillip
Thomas, Ben
Keywords: Chyle Leak
Retroperitoneal Lymph Node Dissection
Chylous Ascites
Retroperitoneal Lymphadenopathy
Glue Embolization
Cancer Services, Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Oct-2023
Publisher: Blackwell Science
Citation: BJU Int . 2023 Oct 3
Abstract: Retroperitoneal lymph node dissection (RPLND) is an important part of multimodal therapy for node-positive germ cell malignancy [1-4]. However, due to wide heterogeneity in patient status, disease biology and tumour locations, RPLND can be challenging and risky [1]. One such risk is iatrogenic chylous ascites (CA; 8% of cases) [1]. CA is defined as accumulation of chyle, a lipid-rich lymph fluid in the peritoneal cavity [5]. Morbidity from intra-abdominal chyle extravasation includes delayed wound healing, malnutrition, electrolyte disturbances, and immunosuppression [2, 6]. This morbidity impairs postoperative recovery, delays adjuvant oncological therapy, and detrimentally affects quality of life [2, 4]. Limited reliable data exist to describe the management of this complex condition [1]. We outline a difficult case and then review the literature for treatment strategies and propose a contemporary management algorithm for refractory post-RPLND CA.
DOI: 10.1111/bju.16188
PubMed URL:
ISSN: 1464-4096
Journal Title: BJU international
Type: Journal Article
Affiliated Organisations: Department of Surgery, Royal Melbourne Hospital, University of Melbourne, Victoria, Australia
Division of Cancer Surgery, Peter MacCallum Cancer Centre, Victoria, Australia
Department of Urology, Western Health, Victoria, Australia
Department of Surgery, Bendigo Hospital, Victoria, Australia
Type of Clinical Study or Trial: Case Reports
Appears in Collections:Cancer Services

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