title: [Chyle leak after cervical surgery: Meta analysis--Management strategy].
abstract: OBJECTIVE
  Chyle fistula is a known complication in cervical surgery. It can lead to a postoperative lymphorrhea. There is no consensus on its management. The aim of this work is to propose a management strategy for postoperative chyle leak.
  
  
  METHODS
  A literature review was conducted using PubMed database.
  
  
  RESULTS
  Six prospectives articles were included. The enteral diet allowed a success in 57% of cases, and in these cases a lymph flow less than 580 mL/day. Parenteral nutrition was effective when the flow was less than 1050 mL/day. Reoperation was performed in case of failure of the nutritional treatments.
  
  
  CONCLUSIONS
  Several therapeutics are available. From this meta-analysis, we developed a management strategy. We initiate an enteral diet when lymph flow is less than 500 mL/ day. Parenteral nutrition is used if the flow rate is between 500 and 1000 mL/day or in case of inefficiency of enteral diet during 10 days. Finally, revision surgery is necessary when the flow is greater than 1000 mL/day or when parenteral nutrition was ineffective in 10 days.
authors.forename: Q
authors.initials: Q
authors.lastname: Lisan
authors.forename: T
authors.initials: T
authors.lastname: Langagne
authors.forename: S
authors.initials: S
authors.lastname: De Regloix
authors.forename: E
authors.initials: E
authors.lastname: Martinod
authors.forename: C
authors.initials: C
authors.lastname: Mendiburu
authors.forename: E
authors.initials: E
authors.lastname: Chevalier
mesh_terms: D000465:Algorithms; D002913:Chyle; D004750:Enteral Nutrition / Q000379:methods; D005402:Fistula / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D037981:Neck Dissection / Q000009:adverse effects*; D010289:Parenteral Nutrition, Total / Q000379:methods; D017410:Practice Guidelines as Topic; D012086:Reoperation; D013897:Thoracic Duct / Q000293:injuries*; D016896:Treatment Outcome