泌尿外科手術後的乳糜腹:中山醫學大學附設醫院的10年回顧
蕭其航1、陳順郎1,2、高育琳1,2、王紹全1、陳文榮1、謝佐宜1
1中山醫學大學附設醫院 泌尿科;2中山醫學大學醫學院醫學系
 
Postoperative Chylous Ascites After Urological Surgery: A 10-year Review at Chung-Shan Medical University Hospital
Chi-Hang Hsiao1, Sung-Lang Chen1,2, Yu-Lin Kao1,2, Shao-Chuan Wang1 , Wen-Jung Chen1, Tzuo-Yi Hsieh1
1 Department of Urology, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC
2 School of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC
 
Abstract
 
  Postoperative chylous ascites is a rare complication of urological surgery. We reviewed the chart of urological operation in the past 10 years in Chung Shan Medical University Hospital, and we are going to report and discuss four cases of postoperative chylous ascites in the article. The first two cases were patients underwent nephrectomy with bladder cuff excision for urothelial carcinoma, the third case was the one underwent radical nephrectomy with lymph node dissection, and the last case was a patient had renal transplantation. Adequate survey and immediately diagnose were important since milky-white fluid was found in the drain bag. We checked the triglycerides level of the drainage. Then, we did conservative treatment for the postoperative chylous ascites patient with nothing per os (NPO) and total parenteral nutrition (TPN) given via central line for at least seven days. Since the daily drain amount decreased and became steady, the color of drainage turned from milky-white to light yellow or serosanguinous, a diet containing low fat and/or medium chain triglycerides was asked to follow, and last for weeks. Elongating the time of drain placement was suggested, and even more let the patient discharged home with the drain. The outcome of all four patients were good, there is no more uncomfortable abdominal symptoms or milky-white fluid accumulated. In our opinions, the conservative treatment for chylous ascites after urological surgery was feasible.
 
 

 
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    台灣泌尿科醫學會
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    2016-05-29 13:11:00
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    2016-05-29 13:12:20
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