Nutritional management in patients with chyle leakage: a systematic review.
OBJECTIVE
To investigate all the available evidence assessing the effect of nutrition intervention on patients with chyle leakage and its effectiveness at reducing the need for surgical intervention.


METHODS
A systematic review was undertaken of all English language studies using MEDLINE, Cinahl and Web of Science from January 1980 to September 2013. Case series were included because of limited available evidence. Exclusion criteria included animal studies, pediatrics and studies without nutritional intervention. Assessment of study quality was included. Because of the heterogeneity of the data, no meta-analysis was performed.


RESULTS
Thirty-one articles were identified for analysis, all of which were retrospective case series studies. The data within these studies were greatly limited. A total of 550 subjects were identified from these studies, 72% of whom had a chyle leak successfully resolved without surgical intervention. However, there was no significant difference between the type of dietary intervention and the rate of resolution (χ(2)=11.14, P=0.08).


CONCLUSIONS
Although there is evidence to suggest that nutrition may have a role in the management of patients with chyle leakage, it is not possible to determine which dietary methods are most effective. More research is required before any guidelines for best practice can be established.
School of Clinical Nutrition, University of Sydney, Sydney, New South Wales, Australia.
B R
BR
Steven
1] School of Clinical Nutrition, University of Sydney, Sydney, New South Wales, Australia [2] Nutrition and Dietetics Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
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Carey
D000328:Adult; D057868:Anastomotic Leak / Q000178:diet therapy* / Q000503:physiopathology; D002210:Caprylates / Q000627:therapeutic use; D002913:Chyle; D018752:Diet, Fat-Restricted; D005526:Food, Formulated; D006801:Humans; D008208:Lymphatic System / Q000293:injuries* / Q000503:physiopathology; D044342:Malnutrition / Q000209:etiology / Q000517:prevention & control*; D010257:Paraneoplastic Syndromes / Q000178:diet therapy* / Q000503:physiopathology; D010289:Parenteral Nutrition, Total; D057285:Precision Medicine; D014280:Triglycerides / Q000627:therapeutic use
D002210:Caprylates; D014280:Triglycerides; C559070:tridecanoin; C003637:tricaprylin; C004565:trilaurin; C010800:tricaprin