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http://dx.doi.org/10.3857/roj.2017.00178

Low-dose radiation therapy for massive chylous leakage after subtotal gastrectomy  

Kim, Sang-Won (Department of Radiation Oncology, Konyang University College of Medicine)
Kim, Jung Hoon (Department of Radiation Oncology, Konyang University College of Medicine)
Publication Information
Radiation Oncology Journal / v.35, no.4, 2017 , pp. 380-384 More about this Journal
Abstract
Massive chylous leakage is a rare postoperative complication that can prolong hospital stay and cause secondary morbidities. Conservative management strategies are the treatment of choice; however, radiation therapy (RT) can be used as an alternative for cases that are refractory to conservative treatment. Herein, we report a 69-year-old female patient who suffered from massive chylous leakage after subtotal gastrectomy. Due to persistent massive chylous leakage, she was scheduled to undergo low-dose RT. Radiation was delivered with a daily dose of 1 Gy, using an anterior-posterior and posterior-anterior beam arrangement. The clinical target volume encompassed the entire lymph node area of the D2 dissection. RT was completed at the total dose of 8 Gy because the amount of chylous leakage declined rapidly. Percutaneous drainage tube was removed after 3 days of RT. The patient did not complain of any symptoms related to massive chylous leakage 2 years after the completion of RT.
Keywords
Chylous ascites; Radiotherapy; Gastrectomy;
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1 Weniger M, D'Haese JG, Angele MK, Kleespies A, Werner J, Hartwig W. Treatment options for chylous ascites after major abdominal surgery: a systematic review. Am J Surg 2016;211:206-13.   DOI
2 Neu B, Gauss G, Haase W, Dentz J, Husfeldt KJ. Radiotherapy of lymphatic fistula and lymphocele. Strahlenther Onkol 2000;176:9-15.   DOI
3 Dietl B, Pfister K, Aufschlager C, Kasprzak PM. [Radiotherapy of inguinal lymphorrhea after vascular surgery: a retrospective analysis]. Strahlenther Onkol 2005;181:396-400.   DOI
4 Mayer R, Sminia P, McBride WH, et al. Lymphatic fistulas: obliteration by low-dose radiotherapy. Strahlenther Onkol 2005;181:660-4.   DOI
5 Perez J, Arribas JM, Cardenas E, Gutierrez F, Taboada R, Cassinello N. Radiotherapeutic management of the chyloperitoneum following abdominal aortic aneurysm repair. J Vasc Surg Venous Lymphat Disord 2013;1:409-11.   DOI
6 Collard JM, Laterre PF, Boemer F, Reynaert M, Ponlot R. Conservative treatment of postsurgical lymphatic leaks with somatostatin-14. Chest 2000;117:902-5.   DOI
7 Sziklavari Z, Allgauer M, Hubner G, et al. Radiotherapy in the treatment of postoperative chylothorax. J Cardiothorac Surg 2013;8:72.   DOI
8 Corradini S, Liebig S, Niemoeller OM, Zwicker F, Lamade W. Successful radiation treatment of chylous ascites following pancreaticoduodenectomy. Strahlenther Onkol 2015;191:448-52.   DOI
9 Kuboki S, Shimizu H, Yoshidome H, et al. Chylous ascites after hepatopancreatobiliary surgery. Br J Surg 2013;100:522-7.   DOI
10 Connor S, Alexakis N, Garden OJ, Leandros E, Bramis J, Wigmore SJ. Meta-analysis of the value of somatostatin and its analogues in reducing complications associated with pancreatic surgery. Br J Surg 2005;92:1059-67.   DOI
11 Aalami OO, Allen DB, Organ CH. Chylous ascites: a collective review. Surgery 2000;128:761-78.   DOI
12 Gerstein J, Kofahl-Krause D, Fruhauf J, Bremer M. Complete remission of a lymphoma-associated chylothorax by radiotherapy of the celiac trunk and thoracic duct. Strahlenther Onkol 2008;184:484-7.   DOI
13 Laila K, Klaus H, Ho AD, Jurgen D, Mathias WH. Successful abdominal irradiation in two patients with therapy-resistant chylous ascites due to follicular lymphoma. Ann Hematol 2016;95:1563-5.   DOI