Novel Technique to Manage Refractory Chylous Ascites with Carbon Nanoparticle Suspension in Infants
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In brief
In brief
This study demonstrates that carbon nanoparticle suspension injection during laparotomy significantly improves identification of lymphatic leakage sites in infants with refractory chylous ascites. In a cohort of 12 infants, the two patients who received CNS-guided surgery achieved successful resolution of their condition, suggesting this technique enhances surgical outcomes compared to conventional approaches.
Written by the GCMD Library team from the article.
Objective
Chylous ascites (CA) is a rare form of ascites that results from the leakage of lipid-rich lymph into the peritoneal cavity. In infants, CA is mostly caused by lymphatic malformation or unknown reasons. The creation of a shunt for the lymphorrhea is the last option for patients unresponsive to all other conservative treatments. Localization of the leakage is a critical problem during surgery. We applied a carbon nanoparticle suspension (CNS) in CA patients to locate the external lymphatic leakage and evaluated its utility during surgery.
Patients and methods
Twelve infants with CA were treated in our center recently. Ten patients received laparotomy, one refused therapy, and one was cured after undergoing conservative treatment. Recently, two infants with CA received CNS in the visceral peritoneum during laparotomy. The results of the traditional procedure were compared to our innovative technique for CA to evaluate the use of CNS in treating CA.
Results
The features of the baseline data did not differ substantially. Location of the leakage with CNS was employed in 2 of the 10 patients whose lymphatic leakages were identified with the resolution of the refractory CA. Overall, in 5 patients, ascites was resolved successfully. The refractory CA was resolved more effectively in patients in whom the leakage site was identified with CNS than in patients in whom the leakage site could not be identified under conventional surgery.
Conclusions
Injecting CNS improved the accuracy of lymphorrhagia leakage site identification and the outcomes of infants who underwent surgical treatment for refractory CA.
Level of evidence
II–III.