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

 

Chi-Hang Hsiao¹, Sung-Lang Chen^1,2, Yu-Lin Kao^1,2, 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

 

 

  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.