The Experts below are selected from a list of 294 Experts worldwide ranked by ideXlab platform
Tae Gyun Kwon - One of the best experts on this subject based on the ideXlab platform.
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Chylous Ascites as a Complication of Laparoscopic Nephrectomy
The Journal of urology, 2010Co-Authors: Bum Soo Kim, Eun Sang Yoo, Tae-hwan Kim, Tae Gyun KwonAbstract:Purpose: Chylous Ascites is a rare complication after major retroperitoneal surgery. Recently Chylous Ascites has developed more often after laparoscopic nephrectomy since that is increasingly done for various indications at many centers. We reviewed our cases of Chylous Ascites after laparoscopic nephrectomy.Materials and Methods: Between January 2002 and December 2008 we performed 622 transperitoneal laparoscopic nephrectomies. We retrospectively analyzed factors related to Chylous Ascites as a complication of laparoscopic nephrectomy.Results: The overall incidence of Chylous Ascites was 5.1% (32 of 622 cases), including 4 severe refractory cases (0.6%). The difference in incidence by operation type was not statistically different (p = 0.251). Chylous Ascites developed more often after left than right nephrectomy (7.3% or 25 of 343 cases vs 2.5% or 7 of 279, p = 0.010). In patients with radical nephrectomy and nephroureterectomy the incidence was higher in those who did vs did not undergo lymphadenectom...
Mahesh Desai - One of the best experts on this subject based on the ideXlab platform.
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Management Protocol for Chylous Ascites After Laparoscopic Nephrectomy.
Urology, 2015Co-Authors: Ankush Jairath, Abhishek Singh, Arvind Ganpule, Shashikant Mishra, Ravindra Sabnis, Mahesh DesaiAbstract:Objective To devise a management protocol for Chylous Ascites after laparoscopic nephrectomy. Patients and Methods We retrospectively reviewed the data of the patients that underwent laparoscopic nephrectomy between January 2010 and January 2014 in our institution for different indications and were diagnosed with Chylous Ascites. We also analyzed a different management protocol that was used. Results The overall incident rate of Chylous Ascites was 0.77%. It was more commonly seen on left side and with simple nephrectomy rather than radical. Three out of 9 patients were managed by surgical intervention, rest were successfully managed on conservative treatment in the form of dietary modification, total parenteral nutrition, or octreotide. Conclusion Chylous Ascites is a rare but morbid condition following laparoscopic nephrectomy. To manage this complication, we propose preventive and treatment strategies based on symptoms and amount of Chylous Ascites using our experience and review of the literature.
Thomas C Bower - One of the best experts on this subject based on the ideXlab platform.
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management of refractory Chylous Ascites with peritoneovenous shunts
Journal of vascular surgery. Venous and lymphatic disorders, 2017Co-Authors: Ying Huang, Peter Gloviczki, Audra Duncan, Mark D Fleming, David J Driscoll, Manju Kalra, Gustavo S Oderich, Thomas C BowerAbstract:Abstract Objective The purpose of this study was to define outcome of treatments of refractory Chylous Ascites using peritoneovenous shunts (PVSs). Methods Clinical data of patients with refractory Chylous Ascites treated with PVSs between 1992 and 2015 were retrospectively reviewed. The primary end point was clinical benefit, defined as cured, improved, or poor results; secondary end points were complications and reinterventions. Results Seventeen patients (eight female [47%]; median age, 47 years [range, 19-78 years]) with refractory Chylous Ascites were studied. This group represented 6% of 284 patients treated for Chylous Ascites during the study period. The etiology was primary lymphangiectasia in 10 patients (59%) and secondary Chylous Ascites due to previous surgery, lymphatic obstruction with associated portal hypertension, or malignant tumor in 7 (41%). Eleven patients were treated with LeVeen shunts and six with Denver shunts. Thirty-day mortality, morbidity, and reintervention rates were 5.9%, 18%, and 12%, respectively. Reintervention rate at 6 months was 9.1% with LeVeen shunt, significantly lower than 100% with Denver shunt (P = .001). During a mean follow-up of 5.1 years (range, 17 days-22.7 years), 7 of 11 patients with LeVeen shunt and all 6 patients with Denver shunt required shunt replacement. Median duration of patency was 215 days (range, 2 days-9.0 years) of a total of 25 LeVeen shunts placed in 11 patients and 44 days (range, 6-91 days) of 20 Denver shunts placed in 6 patients. At last follow-up, patency of the LeVeen shunt was 36% (4/11); symptoms improved in 64% of the patients (7/11). Patency rate of Denver shunts was 33% (2/6), and symptoms improved in 33% (2/6). Conclusions Treatment of refractory Chylous Ascites continues to be a major challenge. The only currently available PVS, the Denver shunt, had a median patency period of
Jacob Ramon - One of the best experts on this subject based on the ideXlab platform.
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the diagnosis and management of postoperative Chylous Ascites
The Journal of Urology, 2002Co-Authors: Ilan Leibovitch, Yoram Mor, Jacob Golomb, Jacob RamonAbstract:Purpose: Postoperative Chylous Ascites is a rare complication of retroperitoneal and mediastinal surgery that represents a difficult management problem due to the serious mechanical, nutritional and immunological consequences of the constant loss of protein and lymphocytes. We reviewed the topic of postoperative Chylous Ascites with special emphasis on the relevant diagnostic and imaging modalities. We propose a novel management algorithm.Materials and Methods: We performed a MEDLINE search of the literature on Chylous Ascites using chyloperitoneum as the subject heading and Chylous Ascites as an additional key word. The search yielded 651 articles. We focused on 102 series, collective reviews and mainly case reports related to the issue of postoperative Chylous Ascites.Results: We propose a novel algorithm based on a step-up approach aimed at promoting decreased lymph production and flow as well as maintaining nutritional balance. The management algorithm integrates repeat palliative paracentesis, dietar...
Bum Soo Kim - One of the best experts on this subject based on the ideXlab platform.
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Chylous Ascites as a Complication of Laparoscopic Nephrectomy
The Journal of urology, 2010Co-Authors: Bum Soo Kim, Eun Sang Yoo, Tae-hwan Kim, Tae Gyun KwonAbstract:Purpose: Chylous Ascites is a rare complication after major retroperitoneal surgery. Recently Chylous Ascites has developed more often after laparoscopic nephrectomy since that is increasingly done for various indications at many centers. We reviewed our cases of Chylous Ascites after laparoscopic nephrectomy.Materials and Methods: Between January 2002 and December 2008 we performed 622 transperitoneal laparoscopic nephrectomies. We retrospectively analyzed factors related to Chylous Ascites as a complication of laparoscopic nephrectomy.Results: The overall incidence of Chylous Ascites was 5.1% (32 of 622 cases), including 4 severe refractory cases (0.6%). The difference in incidence by operation type was not statistically different (p = 0.251). Chylous Ascites developed more often after left than right nephrectomy (7.3% or 25 of 343 cases vs 2.5% or 7 of 279, p = 0.010). In patients with radical nephrectomy and nephroureterectomy the incidence was higher in those who did vs did not undergo lymphadenectom...