Lymphatic ascites following pelvic and paraaortic lymphadenectomy procedures for gynecologic malignancies

M. K. Frey, N. M. Ward, T. A. Caputo, J. Taylor, M. J. Worley, Brian Slomovitz

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objective: Lymphatic ascites is an unusual complication in patients with cancer. In the gynecologic oncology patient population, the most common etiology is operative lymph node dissection. The purpose of this study was to explore the incidence, presenting symptoms, methods of diagnosis and treatment modalities utilized for lymphatic ascites in patients undergoing lymph node dissection for gynecologic cancers. Methods: This observational study retrospectively reviewed the charts of patients who underwent lymphadenectomy as part of the surgical management for a gynecologic cancer. Patients that developed postoperative lymphatic ascites between January 2000 and December 2010 were included for analysis. Data extracted from the medical records included tumor pathology, number of harvested lymph nodes, postoperative course, method of diagnosis and treatment. Results: From a total of 300 surgical staging procedures, 12 patients with lymphatic ascites were identified (4%). The most common reported symptom was leakage of clear fluid per vagina (7, 58%), followed by abdominal distension (4, 33%). The median interval from surgery to development of symptoms was 12.5 days (range 0-22 days). 5 patients had complete resolution of symptoms with dietary modifications alone while 7 patients required paracentesis. The median time from surgery to resolution of symptoms was 44 days (range 9-99). Conclusion: Lymphatic ascites is an under recognized and infrequently reported postoperative complication. Although it usually resolves spontaneously or with conservative management without sequelae, this condition can significantly prolong postoperative recovery and cause patient discomfort. To our knowledge this is the largest group of patients undergoing gynecologic surgical staging procedures to be reviewed for the occurrence of lymphatic ascites.

Original languageEnglish (US)
Pages (from-to)48-53
Number of pages6
JournalGynecologic Oncology
Volume125
Issue number1
DOIs
StatePublished - Apr 2012
Externally publishedYes

Fingerprint

Lymph Node Excision
Ascites
Neoplasms
Diet Therapy
Paracentesis
Gynecologic Surgical Procedures
Vagina
Medical Records
Observational Studies
Lymph Nodes
Pathology
Incidence
Therapeutics

Keywords

  • Gynecologic malignancy
  • Lymphadenectomy
  • Lymphatic ascites

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Lymphatic ascites following pelvic and paraaortic lymphadenectomy procedures for gynecologic malignancies. / Frey, M. K.; Ward, N. M.; Caputo, T. A.; Taylor, J.; Worley, M. J.; Slomovitz, Brian.

In: Gynecologic Oncology, Vol. 125, No. 1, 04.2012, p. 48-53.

Research output: Contribution to journalArticle

Frey, M. K. ; Ward, N. M. ; Caputo, T. A. ; Taylor, J. ; Worley, M. J. ; Slomovitz, Brian. / Lymphatic ascites following pelvic and paraaortic lymphadenectomy procedures for gynecologic malignancies. In: Gynecologic Oncology. 2012 ; Vol. 125, No. 1. pp. 48-53.
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abstract = "Objective: Lymphatic ascites is an unusual complication in patients with cancer. In the gynecologic oncology patient population, the most common etiology is operative lymph node dissection. The purpose of this study was to explore the incidence, presenting symptoms, methods of diagnosis and treatment modalities utilized for lymphatic ascites in patients undergoing lymph node dissection for gynecologic cancers. Methods: This observational study retrospectively reviewed the charts of patients who underwent lymphadenectomy as part of the surgical management for a gynecologic cancer. Patients that developed postoperative lymphatic ascites between January 2000 and December 2010 were included for analysis. Data extracted from the medical records included tumor pathology, number of harvested lymph nodes, postoperative course, method of diagnosis and treatment. Results: From a total of 300 surgical staging procedures, 12 patients with lymphatic ascites were identified (4{\%}). The most common reported symptom was leakage of clear fluid per vagina (7, 58{\%}), followed by abdominal distension (4, 33{\%}). The median interval from surgery to development of symptoms was 12.5 days (range 0-22 days). 5 patients had complete resolution of symptoms with dietary modifications alone while 7 patients required paracentesis. The median time from surgery to resolution of symptoms was 44 days (range 9-99). Conclusion: Lymphatic ascites is an under recognized and infrequently reported postoperative complication. Although it usually resolves spontaneously or with conservative management without sequelae, this condition can significantly prolong postoperative recovery and cause patient discomfort. To our knowledge this is the largest group of patients undergoing gynecologic surgical staging procedures to be reviewed for the occurrence of lymphatic ascites.",
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N2 - Objective: Lymphatic ascites is an unusual complication in patients with cancer. In the gynecologic oncology patient population, the most common etiology is operative lymph node dissection. The purpose of this study was to explore the incidence, presenting symptoms, methods of diagnosis and treatment modalities utilized for lymphatic ascites in patients undergoing lymph node dissection for gynecologic cancers. Methods: This observational study retrospectively reviewed the charts of patients who underwent lymphadenectomy as part of the surgical management for a gynecologic cancer. Patients that developed postoperative lymphatic ascites between January 2000 and December 2010 were included for analysis. Data extracted from the medical records included tumor pathology, number of harvested lymph nodes, postoperative course, method of diagnosis and treatment. Results: From a total of 300 surgical staging procedures, 12 patients with lymphatic ascites were identified (4%). The most common reported symptom was leakage of clear fluid per vagina (7, 58%), followed by abdominal distension (4, 33%). The median interval from surgery to development of symptoms was 12.5 days (range 0-22 days). 5 patients had complete resolution of symptoms with dietary modifications alone while 7 patients required paracentesis. The median time from surgery to resolution of symptoms was 44 days (range 9-99). Conclusion: Lymphatic ascites is an under recognized and infrequently reported postoperative complication. Although it usually resolves spontaneously or with conservative management without sequelae, this condition can significantly prolong postoperative recovery and cause patient discomfort. To our knowledge this is the largest group of patients undergoing gynecologic surgical staging procedures to be reviewed for the occurrence of lymphatic ascites.

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