| 摘要: |
| ［摘要］ 乳糜漏是妇科恶性肿瘤淋巴结切除术后少见但严重的并发症，其发生与高位腹主动脉旁淋巴结切除、腹腔镜操作及围手术期营养不良等因素密切相关。临床诊断需结合乳糜样引流液量≥200 mL/d及其甘油三酯>200 mg/dL等标准。治疗上推荐阶梯式方案：首选保守治疗（调整饮食联合药物治疗等），无效者行淋巴管造影联合或不联合栓塞，难治病例考虑手术结扎或淋巴-静脉吻合术。强调通过术中精细操作、生物制剂应用及术后延迟拔管等综合措施预防乳糜漏。该共识的制订为妇科恶性肿瘤淋巴结切除术后乳糜漏的临床规范化管理提供循证依据。 |
| 关键词: 乳糜漏 妇科恶性肿瘤 淋巴结切除术后 专家共识 |
| DOI：10.3969/j.issn.1674-3806.2025.10.01 |
| 分类号:R 737.3 |
| 基金项目:广西自然科学基金项目（编号：2025GXNSFDA069002，2025GXNSFAA069050）；广西医科大学第一附属医院临床研究攀登计划项目（编号：YYZS2024006） |
|
| Chinese expert consensus on the diagnosis and treatment of chylous ascites after lymphadenectomy for gynecological malignancies(2025 edition) |
|
Chinese Anti-Cancer Association Committee for Integrative Traditional Chinese-Western Medicine in Ovarian Cancer, Obstetrics and Gynecology Branch of Guangxi Medical Association
|
|
-
|
| Abstract: |
| ［Abstract］ Chylous ascites is a rare but serious complication after lymph node resection for gynecological malignancies. Its occurrence is closely related to high-level para-aortic lymph node resection, laparoscopic operation and perioperative malnutrition. Clinical diagnosis of chylous ascites requires a combination of criteria such as a chylous fluid drainage volume ≥200 mL/d and a triglyceride level exceeding 200 mg/dL in the fluid. A stepwise therapeutic approach is recommended: conservative management(dietary modification combined with pharmacological therapy) as the first-line treatment, followed by lymphangiography in or in no combination with embolization for the patients who have failed to respond to the conservative treatment, and surgical ligation or lymphovenous anastomosis for refractory cases. The consensus emphasizes preventing chylous ascites through comprehensive measures such as meticulous intraoperative operations, the application of biological agents, and delayed extubation after surgery. The formulation of this consensus provides an evidence-based foundation for the standardized clinical management of chylous ascites after lymphadenectomy for gynecological malignancies. |
| Key words: Chylous ascites Gynecological malignancies Post-lymphadenectomy Expert consensus |
