Evidence map›Paper›PMID 34860128›Full record

SynthesisAnnals of the Royal College of Surgeons of England2022

The management of chyle leak post-oesophagectomy for oesophageal carcinoma: a systematic review.

A V Robinson, L Kennedy, T Roper, M Khan, S Jaunoo, Brighton Oesophago-Gastric Research Group

Abstract readSystematic Review
In one paragraph

Synthesis in Annals of the Royal College of Surgeons of England, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

A V RobinsonUniversity Hospitals Sussex NHS Foundation Trust, UK.
L KennedyUniversity Hospitals Sussex NHS Foundation Trust, UK.
T RoperUniversity Hospitals Sussex NHS Foundation Trust, UK.
M KhanUniversity Hospitals Sussex NHS Foundation Trust, UK.
S JaunooUniversity Hospitals Sussex NHS Foundation Trust, UK.
Brighton Oesophago-Gastric Research Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionChyle leak is an uncommon yet potentially fatal complication of oesophagectomy for oesophageal cancer. The management of chyle leak is a debated, controversial topic and to date there is no standardised approach or validated algorithm for its management. This review aims to summarise current treatment algorithms for chyle leak post-oesophagectomy and their outcomes.

methodsA systematic search of Embase, MEDLINE, UpToDate and Cochrane was conducted to identify studies reporting on the management of chyle leak following oesophagectomy for oesophageal cancer. Data on interventional success rate and mortality are reported.

findingsTwenty-one studies met the inclusion criteria including over 23,254 oesophagectomies and identifying 838 chyle leaks (incidence <3.6%). The majority of cases were initially managed conservatively (95.3%), with a failure rate of 50.4%. Immediate surgical or radiological management resolved chylothorax in the majority of cases (97.3%), however the numbers were small. Death occurred in 54 cases (6.6%), all of whom underwent conservative management initially.

conclusionsOwing to the heterogeneity of treatment algorithms, timings and indications for interventions, the optimal strategy for managing chyle leak remains unclear. This review has identified an unmet need for prospective multicentre studies assessing the efficacy of predefined algorithms.

Indexed as

ChyleChylothoraxEsophageal NeoplasmsEsophagectomyHumansProspective StudiesChyleGeneral surgeryOesophageal neoplasmsOesophagectomyOesophagusThoracic duct

Identifiers

PMID34860128
PMCPMC9246555

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.