Abstract | PURPOSE: MATERIALS AND METHODS: From April 2001 to March 2019 all patients with refractory chylous ascites after retroperitoneal lymph node dissection treated with peritoneovenous shunt were reviewed. Demographic characteristics, technical success, efficacy, patency period and complications were studied. Univariate and multivariate logistic regression analysis was performed to identify predictors of complications. RESULTS: Twenty patients were included in this study. Testicular cancer was the most common malignancy (85%). The mean number of days from surgery to detection of chylous ascites was 21 days (SD 15, range 4 to 65). Ascites permanently resolved after peritoneovenous shunt in 18 patients (90%), leading to shunt removal in 17 patients (85%) between 46 and 481 days (mean 162, SD 141). The mean serum albumin level increased 24% after shunt placement (mean 3.0±0.6 gm/dl before, 3.9±0.8 gm/dl after, p <0.05). The most common complication was occlusion (30%). Relative risk of complications increased significantly when shunt placement was more than 70 days after surgery and in patients with more than 5 paracenteses before peritoneovenous shunt placement (AR 0.71% vs 0.25%, RR 2.9, p <0.048 and AR 0.6% vs 0.125%, RR 4.8, p <0.04, respectively). CONCLUSIONS:
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Authors | Hooman Yarmohammadi, Juliana Schilsky, Jeremy C Durack, Lynn A Brody, Ulrika Asenbaum, Sara Velayati, Ernesto Santos, Adrian J Gonzalez-Aguirre, Joseph P Erinjeri, Nadia Petre, Stephen B Solomon, Joel Sheinfeld, George I Getrajdman |
Journal | The Journal of urology
(J Urol)
Vol. 204
Issue 4
Pg. 818-823
(10 2020)
ISSN: 1527-3792 [Electronic] United States |
PMID | 32364837
(Publication Type: Journal Article)
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Chylous Ascites
(surgery)
- Humans
- Lymph Node Excision
(methods)
- Lymphatic Metastasis
- Male
- Middle Aged
- Peritoneovenous Shunt
- Postoperative Complications
(epidemiology, surgery)
- Prognosis
- Retroperitoneal Space
- Retrospective Studies
- Risk Factors
- Treatment Outcome
- Urologic Neoplasms
(pathology, surgery)
- Young Adult
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