Published online Jun 27, 2021. doi: 10.4240/wjgs.v13.i6.585
Peer-review started: January 18, 2021
First decision: April 19, 2021
Revised: April 24, 2021
Accepted: May 19, 2021
Article in press: May 19, 2021
Published online: June 27, 2021
Processing time: 150 Days and 23.7 Hours
Chylous ascites or chyle leak after colorectal surgery remains a relatively rare complication.
There has been an increase in the uptake of complete mesocolic resection (CME) or D3 lymphadenectomy in colorectal surgery. As a result, it is thought that this is an important risk factor for chylous ascites or chyle leak.
The aim of this study was to perform a systematic review on all evidence on chylous ascites or chyle leak after colorectal surgery to describe its incidence, clinical presentation, risk factors and management options.
A systematic review of the literature was performed by searching PubMed, MEDLINE, EMBASE and Cochrane databases up to November 2020.
From 2000 to 2010, 59 cases of chylous ascites or chyle leak were reported. Between 2011 to 2020, there was a six-fold increase in number of cases reported. The estimated incidence of chylous ascites or chyle leak after colorectal surgery from these series is 5.5%.
Chylous ascites or chyle leak after colorectal surgery is a rare complication especially in the Western world. Whilst the majority of cases resolve with conservative management, meticulous dissection and clipping of lymphatics especially during extended lymphadenectomy are vital to prevent this complication and its associated morbidity.
Future colorectal trials should include this as a reported complication given the increasing number of CME and D3 Lymphadenectomy.