Abstract: Objective To summarize the etiology,treatment and preventive experience of the chylous fistula after radical resection of colon carcinoma plus D3 lymph node dissection.Methods 628 cases of the chylous fistula after radical resection of colon carcinoma plus D3 lymph node dissection were analyzed retrospectively.The incidence of the chylous fistula in different surgical methods(the Laparotomy Group and the laparoscopy group)and different surgical sites(left colon cancer and right colon cancer)was compared.Results Chylorrhea occurred in 22 patients(3.5%),including 2.8%(8/286)in the Laparotomy Group and 4.0%(14/342)in the Laparotomy Group,and the differences were no statistical significance(P＞0.05).Incidence of the chylous fistula in radical resection of right-colon carcinoma plus D3 lymph node dissection was 7.8%(16/207),while incidence of the chylous fistula in radical resection of right-colon carcinoma plus D3 lymph node dissection was 1.4%(6/421).There was statistical significance(P＜0.05),and there was no significant statistical significance between different TNM stages and incidence of the chylous fistula(P＞0.05).Twenty-one patients received conservative treatment(abrosia,total parenteral nutrition,somatostatin infusion,anti-infection,delaying removing drainage tubes)were successfully cured,and one patient required re-operation.No patients had recurrence and died.Conclusion There is no statistical significance between the Laparotomy Group and the laparoscopy group.Radical resection of right-colon carcinoma plus D3 lymph node dissection is associated with higher risk for chyle leak.Conservative treatment is effective in early stage of chyle leak after radical resection of colon carcinoma plus D3 lymph node dissection.