Therapy of chylous ascites after laparotomy for abdominal metastasis of breast cancer

Objectives:To observe the effectivenessof the nutritional therapy in postoperative chylous ascites caused by laparotomy for abdominal metastasis of breast cancer. Methods:Omentectomy, gastrojejunostomy and jejunostomy were performed in an advanced breast cancer patient for abdominal metastasis. Postoperative tube feeding with Ensure was used and chylous ascites appeared in day 11 after operation. Then the enteral nutrition was substituted by total parenteral nutrition for a week, followed by a fat free enteral nutrion formula (fat free soya bean protein powder and sucrose) and at last an oral low fat diet. Results:Two days after cessation of tube feeding of Eusure, the Sudan Ⅲ stain of ascites became negative, accompanied with decrease of the concentration of triglyceride and drainage volume. Such trend had been kept during the fat free enteral nutrition and up to 30 days after laparotomy,and then the drain tube was withdrawn. Conclusions:For chylous ascites caused by abdominal operation for metastatic cancer, non operative therapy may be the most practical method. Early detection and proper nutritional therapy may get a dramatic result in a short interval.