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 Lei
Department of Thoracic Surgery, Sun Yat-sen University, the First Affiliated Hospital, Guangzhou, Guangdong, P. R. China
,
Yanfen Feng
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P. R. China
Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P. R. China
,
Bo Zeng
Department of Thoracic Surgery, Sun Yat-sen University, the First Affiliated Hospital, Guangzhou, Guangdong, P. R. China
,
Xin Zhang
Department of Thoracic Surgery, Sun Yat-sen University, the First Affiliated Hospital, Guangzhou, Guangdong, P. R. China
,
Jingfu Chen
Department of Oncology, The Third People's Hospital of Dongguan City, Dongguan, Guangdong, P. R. China
,
Jianyong Zou
Department of Thoracic Surgery, Sun Yat-sen University, the First Affiliated Hospital, Guangzhou, Guangdong, P. R. China
,
Chunhua Su
Department of Thoracic Surgery, Sun Yat-sen University, the First Affiliated Hospital, Guangzhou, Guangdong, P. R. China
,
Zhenguo Liu
Department of Thoracic Surgery, Sun Yat-sen University, the First Affiliated Hospital, Guangzhou, Guangdong, P. R. China
,
Honghe Luo
Department of Thoracic Surgery, Sun Yat-sen University, the First Affiliated Hospital, Guangzhou, Guangdong, P. R. China
,
Shuishen Zhang
Department of Thoracic Surgery, Sun Yat-sen University, the First Affiliated Hospital, Guangzhou, Guangdong, P. R. China
› Author Affiliations
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.).