Issue N# 3 - 2014
Chyle leak after cervical surgery: Meta analysis - Management strategy
Authors : Lisan Q, Langagne T, De Regloix S, Martinod E, Mendiburu C, Chevalier E. (Montfermeil)
Ref. : Rev Laryngol Otol Rhinol. 2014;135,3:141-144.
Article published in french
Downloadable PDF document french
Objective: Chyle fistula is a known complication in cervical surgery. It can lead to a postoperative lymphorrhea. There is no consensus on its management. The aim of this work is to propose a management strategy for postoperative chyle leak. Materials and methods: A literature review was conducted using PubMed database. Results: Six prospectives articles were included. The enteral diet allowed a success in 57% of cases, and in these cases a lymph flow less than 580 mL/day. Parenteral nutrition was effective when the flow was less than 1050 mL/day. Reoperation was performed in case of failure of the nutritional treatments. Conclusion: Several therapeutics are available. From this meta-analysis, we developed a management strategy. We initiate an enteral diet when lymph flow is less than 500 mL/ day. Parenteral nutrition is used if the flow rate is between 500 and 1000 mL/day or in case of inefficiency of enteral diet during 10 days. Finally, revision surgery is necessary when the flow is greater than 1000 mL/day or when parenteral nutrition was ineffective in 10 days.
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