ArticleAnnals of surgery open : perspectives of surgical history, education, and clinical approaches2022
Risk Factors, Diagnosis and Management of Chyle Leak Following Esophagectomy for Cancers: An International Consensus Statement.
Article in Annals of surgery open : perspectives of surgical history, education, and clinical approaches, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- International Society for Diseases of the Esophagus consensus on the diagnosis and treatment of anastomotic leak after esophagectomy.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026Guideline
- Chylous leakage after esophagectomy for esophageal cancer: a systematic review.Journal of cardiothoracic surgery · 2024Pooled it
- Best evidence summary for nutritional management of cancer patients with chyle leaks following surgery.Frontiers in nutrition · 2024Pooled it
- Robotic-assisted thoracic duct ligation surgery guided by intralymphatic injection of indocyanine green.Journal of surgical case reports · 2026Article
- Fluorescence Lymphography Using Indocyanine Green During Esophagectomy for Cancer to Prevent Chyle Leakage: A Propensity Score Matched Analysis.Annals of surgical oncology · 2026Observational
- Neoadjuvant Treatment is a Risk Factor for Clinically Relevant Chyle Leak (ISGPS Grade B/C) After Pancreatic Cancer Resection: A Retrospective Cohort Study.Annals of surgical oncology · 2026Article
- A novel short-term outcome prediction model for esophagectomy patients receiving neoadjuvant immunochemotherapy and neoadjuvant chemotherapy: a muti-center retrospective study.Frontiers in oncology · 2026Article
- Review
- Intervention lymphatic leakage after esophageal surgery due to esophageal cancer: A case report.Radiology case reports · 2024Article
- The Anatomy of the Thoracic Duct and Cisterna Chyli: A Meta-Analysis with Surgical Implications.Journal of clinical medicine · 2024Review
- Article
- Utility ofNuclear medicine and molecular imaging · 2023Article
- Postesophagectomy chylothorax: a review of the risk factors, diagnosis, and management.Annals of medicine and surgery (2012) · 2023Article
Corrections and comments
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Authors and funding
45 authors at 20 institutions in 30 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This Delphi exercise aimed to gather consensus surrounding risk factors, diagnosis, and management of chyle leaks after esophagectomy and to develop recommendations for clinical practice. Background: Chyle leaks following esophagectomy for malignancy are uncommon. Although they are associated with increased morbidity and mortality, diagnosis and management of these patients remain controversial and a challenge globally. Methods: This was a modified Delphi exercise was delivered to clinicians across the oesophagogastric anastomosis collaborative. A 5-staged iterative process was used to gather consensus on clinical practice, including a scoping systematic review (stage 1), 2 rounds of anonymous electronic voting (stages 2 and 3), data-based analysis (stage 4), and guideline and consensus development (stage 5). Stratified analyses were performed by surgeon specialty and surgeon volume. Results: In stage 1, the steering committee proposed areas of uncertainty across 5 domains: risk factors, intraoperative techniques, and postoperative management (ie, diagnosis, severity, and treatment). In stages 2 and 3, 275 and 250 respondents respectively participated in online voting. Consensus was achieved on intraoperative thoracic duct ligation, postoperative diagnosis by milky chest drain output and biochemical testing with triglycerides and chylomicrons, assessing severity with volume of chest drain over 24 hours and a step-up approach in the management of chyle leaks. Stratified analyses demonstrated consistent results. In stage 4, data from the Oesophagogastric Anastomosis Audit demonstrated that chyle leaks occurred in 5.4% (122/2247). Increasing chyle leak grades were associated with higher rates of pulmonary complications, return to theater, prolonged length of stay, and 90-day mortality. In stage 5, 41 surgeons developed a set of recommendations in the intraoperative techniques, diagnosis, and management of chyle leaks. Conclusions: Several areas of consensus were reached surrounding diagnosis and management of chyle leaks following esophagectomy for malignancy. Guidance in clinical practice through adaptation of recommendations from this consensus may help in the prevention of, timely diagnosis, and management of chyle leaks.
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