@article{AOE4999,
author = {Brian Ip and Ka Ting Ng and Simon Packer and Simon Paterson-Brown and Graeme Couper},
title = {Oesophagectomy with en bloc resection of the thoracic duct: risk factors for post-operative chyle leak and current management},
journal = {Annals of Esophagus},
volume = {2},
number = {0},
year = {2019},
keywords = {},
abstract = {Background: Routine ligation of the thoracic duct during oesophagectomy has been reported to reduce the rate of chyle leak (CL) following oesophagectomy. This study aims to identify risk factors for developing a CL with this approach and review current management.
Methods: All patients who underwent transthoracic oesophagectomy over a 3-year period were identified from a prospectively collected database and their medical records reviewed.
Results: A total of 147 oesophagectomies were performed in the period January 2012–December 2014. Eighteen patients with anastomotic leak were excluded. Eleven (8.5%) of the remaining 129 patients developed a CL. Statistically significant predictive factors for CL were squamous cell carcinoma (6/16, 37.5% vs. 5/113, 4.4% in other tumour types, P=0.0005) and high total chest drain volumes on day 2 post operatively measured prior to commencing enteric feeding. Using a threshold of 600 mL on day 2, the sensitivity and specificity for predicting CL are 92% and 82% respectively. Low BMI (mean 24.1 with CL vs. 27.5 without CL) was also associated with a CL, but was not statistically significant. Neither the extent of lymphadenectomy nor the extent of lymph node involvement (N stage) were associated with CL. Six patients with a low volume CL (},
issn = {2616-2784}, url = {https://aoe.amegroups.org/article/view/4999}
}