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Chyle Leak Following Radical En Bloc Esophagectomy with Two-Field Nodal Dissection: Predisposing Factors, Management, and Outcomes

Lookup NU author(s): Jakub Chmelo, Dr Lorna Dunn, Anantha Madhavan, Shajahan Wahed, Arul Immanuel, Professor Michael Griffin, Professor Alexander PhillipsORCiD

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Abstract

© 2020, The Author(s). Background: Chyle leak is an uncommon complication following esophagectomy, accounting for significant morbidity and mortality; however, the optimal treatment for the chylothorax is still controversial. Objective: The aim of this study was to evaluate the incidence, management, and outcomes of chyle leaks within a specialist esophagogastric cancer center. Methods: Consecutive patients undergoing esophagectomy for esophageal cancers (adenocarcinoma or squamous cell carcinoma) between 1997 and 2017 at the Northern Oesophagogastric Unit were included from a contemporaneously maintained database. Primary outcome was overall survival, while secondary outcomes were overall complications, anastomotic leaks, and pulmonary complications. Results: During the study period, 992 patients underwent esophagectomy for esophageal cancers, and 5% (n = 50) of them developed chyle leaks. There was no significant difference in survival in patients who developed a chyle leak compared with those who did not (median: 40 vs. 45 months; p = 0.60). Patients developing chyle leaks had a significantly longer length of stay in critical care (median: 4 vs. 2 days; p = 0.002), but no difference in total length of hospital stay. Conclusion: Chyle leak remains a complication following esophagectomy, with limited understanding on its pathophysiology in postoperative recovery. However, these data indicate chyle leak does not have a long-term impact on patients and does not affect long-term survival.

Publication metadata

Author(s): Milito P, Chmelo J, Dunn L, Kamarajah SK, Madhavan A, Wahed S, Immanuel A, Griffin SM, Phillips AW

Publication type: Article

Publication status: Published

Journal: Annals of Surgical Oncology

Year: 2021

Volume: 28

Issue: 7

Pages: 3963-3972

Print publication date: 01/07/2021

Online publication date: 02/12/2020

Acceptance date: 31/10/2020

Date deposited: 01/06/2022

ISSN (print): 1068-9265

ISSN (electronic): 1534-4681

Publisher: Springer Nature

URL: https://doi.org/10.1245/s10434-020-09399-1

DOI: 10.1245/s10434-020-09399-1

PubMed id: 33263829

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