THE MANAGEMENT OF CHYLOUS ASCITES AFTER RADICAL HYSTERECTOMY WITH PELVIC LYMPH NODE DISSECTION: A RARE CASE REPORT

THE MANAGEMENT OF CHYLOUS ASCITES AFTER RADICAL HYSTERECTOMY WITH PELVIC LYMPH NODE DISSECTION: A RARE CASE REPORT

Ioana Delia Clinciu*,**, E.A. Bonci*,***, I.C. Lisencu*,***

* Department of Surgical Oncology, „Ion Kiricuţă” Cancer Center, University of Medicine
and Pharmacy ‘Iuliu Haţieganu’, Cluj-Napoca, Romania
** „Dominic Stanca” Clinic of Obstetrics and Gynecology, Cluj-Napoca County Emergency
Hospital, Cluj-Napoca, Romania
*** Department of Oncology, University of Medicine and Pharmacy ‘Iuliu Haţieganu’,
Cluj-Napoca, Romania

 

Rezumat: Managementul ascitei chiloase după histerectomie radicală cu limfadenectomie pelvină: o raportare de caz clinic rar.

     Fistula chiloasă este o complicaţie rară a limfadenectomiei efectuate în tratamentul neoplaziilor ginecologice. Apariţia acesteia contribuie substanţial la creşterea morbidităţii. Scurgerea chiloasă este asociată cu importante consecinţe nutrţiionale şi imunologice datorită pierderii constante de proteine. Alternativele terapeutice includ măsuri conservatoare sau intervenţia chirurgicală. Raportăm cazul unei paciente de 47 de ani cu fistulă după efectuarea limfadenectomiei pelvine pentru cancer de col uterin radiotratat neoadjuvant. Pacienta a fost tratată cu succes utilizând doar măsuri terapeutice conservative, fără a exista complicaţii sau fără a fi necesare alte intervenţii clinice terapeutice. Cazul nostru demonstrează că managementul terapeutic conservator este eficient în tratarea fistulei chiloase. Cu toate acestea, alternativele terapeutice ar trebui individualizate şi adaptate în funcţie de fiecare pacient.

      

Abstract:

     Chylous fistula is a rare complication after lymphadenectomy for treatment of gynecologic cancer. Its presence contributes substantially to increased morbidity. Chylous leakege is associated with serious nutritional and immunologic consequences due to the constant protein loss. Treatment options include conservative measures or surgical intervention. We report a 47-year-old women with fistula following systematic pelvic lymph node dissection for cervical cancer with neoadjuvant radiotherapy. The pacient was successfully treated by conservative management without complications or other clinical interventions. Our case demonstrated that conservative management is effective in treatment of chylous fistula. However, treatment options should be personalized and the right treatment should be chosen for each patient.

 

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