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Chylous ascites after colorectal cancer surgery: risk factors and impact on short-term and long-term outcomes.

PURPOSE: Data on the incidence, risk factors, and oncologic impact of chylous ascites after colorectal cancer surgery are scarce. In this study, we aimed to assess the risk factors and the short-term and long-term impact of chylous ascites after colorectal cancer surgery.

METHODS: We retrospectively examined 2917 primary colorectal cancer patients who underwent surgical resection between January 2008 and December 2013. The short-term and long-term outcomes were compared between patients with and those without postoperative chylous ascites, and the risk factors for chylous ascites were analyzed.

RESULTS: Chylous ascites developed in 138 (4.7 %) patients. A shorter operative time (odds ratio [OR] 0.992, 95 % confidence interval [CI] 0.988-0.996) and the number of retrieved lymph nodes (OR 1.015, 95 % CI 1.004-1.025) were independent risk factors for postoperative chylous ascites. All patients with chylous ascites were managed conservatively, without surgical intervention. The postoperative hospital stay was similar between the two groups (9.4 vs. 9.2 days, p = 0.467). After a median follow-up of 37 months (range 0-118 months), no significant difference was observed in the 3-year disease-free survival (85.0 vs. 83.9 %, p = 0.408) and 5-year overall survival (93.0 vs. 89.7 %, p = 0.662) between the two groups.

CONCLUSIONS: A major drawback of this study was that the definition of chylous ascites was solely based on clinical signs. Nevertheless, we can conclude that chylous ascites after colorectal cancer surgery is associated with a shorter operative time and the number of retrieved lymph nodes, but is not associated with the short-term and long-term outcomes.

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