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EP1307 Cisterna Chyli: an important landmark in laparoscopic paraaortic lymphadenectomy
  1. NU Dogan1,
  2. S Dogan2,
  3. M Erol3 and
  4. B Tas Uzun1
  1. 1Ob andGyn, Akdeniz University
  2. 2Antalya Resarch and Training Hospital
  3. 3Akdeniz University, Antalya, Turkey


Introduction/Background Cisterna chyli is a pearl shaped elongated lymphatic structure generally located at the level of L1-L2 vertebra just beneath the aorta. It recieves lymphatic drainage of intestines and lower body structures. Size, shape and location are all highly variable and in some autopsy series only in 50% of cases CC was identified. During the laparoscopic paraaortic lymphadenectomy, inadvertant injury of otherwise unidentified CC could lead to refractorry chlous ascites.

Methodology video presentation of two cases

Results Cases: The first case is a 51 year old woman with grade III endometrioid adenocarcinoma of uterus who was subjected to laparoscopic staging (laparoscopic hysterectomy + BSO + pelvic and paraaortic lymphadenectomy). Intraoperatively in paraaortic lymphadenectomy an incidental injury to cisterna chyli occurred which was sealed and repaired immediately. The second case is a woman with stage IIB clear cell cervical cancer who had been laparoscopically staged (pelvic and paraaortic lymphadenectomy). In this case cisterna chyli located just under the renal vein could be recognized and preserved. Having identified the cisterna chyli laparoscopic paraaortic lymphadeenctomy was completed without any complications.

Conclusion Anatomical variations and malformations of lymphatic system could be encountered in paraaortic region similar to vascular malformations. During the laparoscopic paraaortic lymphadenectomy presence of Cisterna chyli below the renal vein should always be kept in mind and this structure should be preserved. Any iatrogenic injury of cisterna chyli could lead to refractory chlylous ascites

Disclosure Nothing to disclose

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