title: Is early surgical management of chylothorax following oesophagectomy beneficial?
abstract: A best evidence topic in surgery was written according to a structured protocol. The question addressed was whether the initial surgical management of chylothorax after oesophagectomy results in a better outcome. Altogether 357 papers were found as a result of the reported search, of which 4 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers were tabulated. Three studies were retrospective and from single centres with small patient numbers, while one study was a prospective, randomized controlled trial, from which a subgroup analysis was included in our results. We conclude that although all studies to date have had very small patient numbers and some contradictory results, there is some evidence that early surgical intervention of chylothorax following oesophagectomy reduces hospital stay when compared with conservative treatment.
authors.affiliation: Department of Surgery, Royal Bournemouth Hospital, Bournemouth, UK okhan342@gmail.com.
authors.forename: Clarisa T P
authors.initials: CT
authors.lastname: Choh
authors.affiliation: Department of Cardio-thoracic Surgery, Royal Victoria Hospital, Belfast, UK.
authors.forename: Igor J
authors.initials: IJ
authors.lastname: Rychlik
authors.affiliation: Department of Cardio-thoracic Surgery, Royal Victoria Hospital, Belfast, UK.
authors.forename: Kieran
authors.initials: K
authors.lastname: McManus
authors.affiliation: Department of Upper GI Surgery, St. George's Hospital, London, UK.
authors.forename: Omar A
authors.initials: OA
authors.lastname: Khan
mesh_terms: D019985:Benchmarking; D002916:Chylothorax / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D019317:Evidence-Based Medicine; D006801:Humans; D007902:Length of Stay; D008026:Ligation; D012086:Reoperation; D012307:Risk Factors; D013897:Thoracic Duct / Q000601:surgery*; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome
keywords: Chylothorax; Oesophagectomy; Surgical management