Premium
The deep inferior epigastric lymphatic cable flap connected to gastroepiploic lymph node flap for treatment of refractory chylous ascites: Report of two cases
Author(s) -
Ciudad Pedro,
Chen HungChi,
Bustos Samyd S.,
Manrique Oscar J.,
Bolletta Alberto,
Forte Antonio J.,
Huayllani Maria T.,
Agko Mouchammed,
Urbina J. Antonio,
Date Shivprasad,
Kaya Burak
Publication year - 2021
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.30736
Subject(s) - chylous ascites , medicine , surgery , lymphatic system , lymphedema , ascites , paracentesis , lymph node , refractory (planetary science) , lymph , peritoneal cavity , cancer , pathology , physics , astrobiology , breast cancer
Chylous ascites is the leakage of lipid‐rich lymph into the peritoneal cavity usually due to disruption of lymphatics or increased peritoneal lymphatic pressure. Various surgical options have been proposed to treat chylous ascites but most have shown suboptimal outcomes. The gastroepiploic vascularized lymph node (GE‐VLN) flap has been described previously for the treatment of lymphedema. In chylous ascites, this flap could provide an alternate drainage pathway for the intraperitoneal chylous fluid. The purpose of this report is to present another option for the microsurgical treatment of refractory chylous ascites. Herein, we report two patients with refractory chylous ascites secondary to cancer who have undergone deep inferior epigastric‐based lymphatic “cable” flap (DIE‐LCF) connected to a pedicle GE‐VLN flap. Patients were followed‐up for a minimum of 2 years. Within the first 3 months following surgery, the patient's nutritional parameters improved along with drastic reduction of ascites. At 2 years follow‐up postoperative abdominal circumference decreased significantly. None required further peritoneal paracentesis and all patients were free of chylous ascites symptoms. In conclusion, the DIE‐LCF connected to a pedicle GE‐VLN flap could be a feasible option for the microsurgical treatment of refractory chylous ascites.