Abstract
Chyloperitoneum is a rare postoperative complication after gastrectomy. We report two cases of chyoperitoneum with paraaortic lymph node metastasis-positive gastric cancer who received neoadjuvant chemotherapy.
Case 1 : A 66-year-old male gastric cancer patient with multiple paraaortic lymph nodes and right supraclavicular lymph node metastases had undergone two cycles of S-1 + CDDP neoadjuvant chemotherapy and had a distal gastrectomy with D2 lymph node dissection as well as paraaortic lymph node sampling for chemotherapy evaluation. Chyloperitoneum occurred one month after the operation. Chyloperitoneum was not cured after three months of consevative treatment (total parenteral nutrition). Thus surgery was undertaken but the lymphatic fistula could not be found ; therefore, definitive surgical treatment was not possible. After the operation, two more weeks of conservative treatment reduced the chyloperitoneum.
Case 2 : A 64-year-old male gastric cancer patient with multiple paraaortic lymph node metastases underwent three cycles of S-1 + CDDP neoadjuvant chemotherapy and had the same operation as described in case 1. Chyloperitoneum occurred one month after the operation. Two months of consevative treatment involving total parenteral nutrition were required to achieve a cure.
Neoadjuvant chemotherapy for multiple paraaortic lymph node metastases could be a risk factor for postgastrectomy chyloperitoneum.
