The complications included postoperative bleeding in three patients and gastrointestinal obstruction and anastomotic and lymphatic fistula
in three patients, and the complication rate was 46.
However, the patient discontinued chemotherapy due to intolerance, after he experienced inguinal signs of inflammation and lymphatic fistula
at the left inguinal area.
Charles procedure is a significant debulky surgery and some complication may develop after this procedure including massive blood loss that needs transfusion poor graft patency that needs regrafting continuous lymphatic fluid oozing postoperative infection unsatisfactory cosmetic result hypertrophic scar papillomatosis recurrent cellulitis and lymphatic fistula
It is important to remember that chyle leaks slowly into the peritoneal cavity through lymphatic fistulas
or by back-pressure on the intestinal lymphatics, and significant quantities of chylous ascites may take some time to accumulate (5).