Academic Journal
Microsurgical Peritoneovenous Bypass for the Treatment of Recalcitrant Chylous Ascites
| العنوان: | Microsurgical Peritoneovenous Bypass for the Treatment of Recalcitrant Chylous Ascites |
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| المؤلفون: | Klifto, Kevin M., Card, Elizabeth B., Itkin, Maxim, Kovach, Stephen J. |
| المصدر: | Plastic & Reconstructive Surgery ; ISSN 0032-1052 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health) |
| سنة النشر: | 2023 |
| الوصف: | Background: New treatments for recalcitrant chylous ascites are needed to avoid sequelae associated with increased intra-abdominal pressures, chyle loss, and diminished quality of life. An autologous microsurgical technique was developed to treat recalcitrant chylous ascites and restore normal physiology. Methods: A retrospective case-series was performed for patients with recalcitrant chylous ascites surgically treated from 2018 to 2020. We included all patients with recalcitrant chylous ascites refractory to current standard of care interventions such as diet modifications, pharmacologic therapies, and peritoneovenous mechanical shunts. All were treated with microsurgical peritoneovenous bypass with a minimum follow-up of 12 months. Results: Six patients were included over a 2-year period. Surgery was aborted for two patients (33%) with intra-operative venous reflux of the deep inferior epigastric vein (DIEV), negative on pre-operative ultrasound. One patient had a successful reoperation using the contralateral greater saphenous vein (GSV), while the other elected for a chronic indwelling drain for chyle drainage. Among the five successful surgeries (83%), ascites drainage decreased from a median pre-operative volume of 1 L/day to post-operative volume of 0.06 L/day. Median hospital length-of-stay (LOS) was 7 days (range: 2-194). Three patients each had one complication, including vancomycin resistant enterococcus (VRE), spontaneous bacterial peritonitis (SBP), and pulmonary embolism (PE). All complications resolved with additional interventions. Median follow-up was 13.5 months (range: 12-27). Conclusions: Microsurgical peritoneovenous bypass was a reliable and reproducible autologous surgery for the treatment of recalcitrant chylous ascites at a minimum follow-up of 12 months. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1097/prs.0000000000010244 |
| DOI: | 10.1097/PRS.0000000000010244 |
| الاتاحة: | http://dx.doi.org/10.1097/prs.0000000000010244 https://journals.lww.com/10.1097/PRS.0000000000010244 |
| رقم الانضمام: | edsbas.31A999D1 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/prs.0000000000010244 |
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