Risk factors and impact of chylous leak after laparoscopic surgery for gynecological malignancies

Purpose :The goal of this retrospective study was to investigate the risk factors and impact for chylous leak after laparoscopic surgery for gynecological malignancies. Methods Data on 495 patients who underwent surgery for gynecologic malignancies in the Department of Gynecology, the Second Hospital of Shandong University from January 2018 to April 2022 were collected. The risk factors related to the occurrence of chylous leak were then analyzed statistically. Results : 394 patients underwent laparoscopic surgery and were divided into two groups according to the occurrence of chylous leak after surgery: 19 patients were in the case group,and 375 patients were in the control group. The incidence of chylous leak in this study was 4.82%. Univariate analysis showed preoperative anemia(p =0 .01)and enlarged lymph nodes (p = 0.008) as risk factors for chylous leak. Statistical analysis of postoperative factors between the two groups showed significantly increased length of hospitalization (p ＝0 .001) and hospitalization costs (p = 0.003), postoperative maximum temperature ( p < 0.001) maximum drain output (p < 0.001), and drainage tube days ( p < 0.001) in the case group compared with the control group. Multivariate binary logistic regression analysis showed that preoperative anemia (OR = 3.111, 95%CI = 1.081–8.953) was the risk factor for chylous leak. Conclusions The occurrence of chylous leakafter laparoscopic surgery for gynecological malignancies leads to prolonged hospital stay, increased medical costs. The possibility of chylous leak occurring after laparoscopic surgery for gynecological malignancies with preoperative anemia is high.