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  Contents > Previous page > Article detail print Order
o Issue N# 3 - 2014 o

CERVICAL SURGERY

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



Summary : 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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