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Octreotide therapy for the management of refractory chylous ascites after a staging operation for endometrial adenocarcinoma
Author(s) -
Kim Eun Ah,
Park Hyun,
Jeong Sang Geun,
Lee Chan,
Lee Joon Mo,
Park Chong Taik
Publication year - 2014
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12183
Subject(s) - medicine , chylous ascites , octreotide , refractory (planetary science) , parenteral nutrition , surgery , lymphadenectomy , lymphatic system , ascites , radiology , somatostatin , lymph node , pathology , physics , astrobiology
Chylous ascites after para‐aortic lymphadenectomy is caused by a rupture in the retroperitoneal lymphatic channels. The incidence of postoperative chylous ascites is increasing as para‐aortic lymphadenectomy for the management of gynecologic malignancies becomes more common. However, management of this condition remains unsatisfactory because some patients do not respond to conservative methods and have to undergo surgical intervention, even though they may be malnourished and immunosuppressed. We report the case of a patient who underwent a standard staging operation for endometrial cancer and experienced a large amount of lymphatic leakage, in spite of treatment with total parenteral nutrition and a low‐fat diet for over 40 days. As a step‐up approach, octreotide, a somatostatin analog, was added and the disease resolved completely. This case demonstrated that octreotide therapy is highly effective in refractory cases of chylous ascites where a large amount of leakage is observed and cases that are otherwise indicated for surgical intervention.