Thorac cardiovasc Surg
DOI: 10.1055/s-0037-1602259
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Effect of Prophylactic Thoracic Duct Ligation in Reducing the Incidence of Postoperative Chylothorax during Esophagectomy: A Systematic Review and Meta-analysis

Yiyan Lei1, Yanfen Feng2, 3, Bo Zeng1, Xin Zhang1, Jingfu Chen4, Jianyong Zou1, Chunhua Su1, Zhenguo Liu1, Honghe Luo1, Shuishen Zhang1
  • 1Department of Thoracic Surgery, Sun Yat-sen University, the First Affiliated Hospital, Guangzhou, Guangdong, P. R. China
  • 2State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P. R. China
  • 3Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P. R. China
  • 4Department of Oncology, The Third People's Hospital of Dongguan City, Dongguan, Guangdong, P. R. China
Further Information

Publication History

22 January 2017

20 March 2017

Publication Date:
02 May 2017 (eFirst)

Abstract

Objectives There is no consensus on the effectiveness of prophylactic thoracic duct ligation (PLG) in esophagectomy for reducing the incidence of postoperative chylothorax. We performed a systemic review and meta-analysis to study its efficacy.

Methods A systemic review of the publications was performed on three databases to identify all the relevant literature on comparative outcomes of PLG and nonprophylactic thoracic duct ligation (NPLG). The primary end point was the incidence of postoperative chylothorax.

Results Seven studies with comparative data on PLG (n = 2,178) versus NPLG (n = 3,048) were identify from the current publications. Comparison showed no significant difference between PLG and NPLG on the incidence of postoperative chylothorax (relative risk = 0.431; 95% confidence interval, 0.186 to 1.002; p = 0.050).

Conclusions Although some studies showed that PLG during the esophagectomy was effective to lower the incidence of postoperative chylothorax, no evidence was observed in the present meta-analysis. Further research is warranted to validate the findings.

Funding

This study was funded by grants from Medical Scientific Research Foundation of Guangdong Province (A2014217 for L.Y.Y., A2014246 for F.Y.Y., and A2016297 for Z.B.).