Nutritional Management in Patients with Chyle Leak following Head and Neck Surgery: A Systematic Review.

OBJECTIVE

We aim to investigate nutritional management of chyle leaks by a systematic review of the published literature.

METHODS

We searched the following databases (Medline, Embase, Cochrane) for literature incorporating nutritional aspects in chyle leak management. We excluded non-English papers, paediatric studies, conference papers, and studies without nutritional intervention.

RESULTS

Among 260 patients (out of 26,270), 81.5.% (n=212/260) achieved chyle leak resolution with nutritional management, while 18.5% (n=48/260) required surgery. Median resolution duration with nutritional management was 8.7 days (range: 4.3 to 22.2), compared to surgical treatment's median of 32 days (range: 18 to 40).

CONCLUSION

We recommend use of nutritional management in all patients with chyle leaks. There is no evidence supporting one diet over the other however clinically we suggest starting with medium-chain triglyceride/non-/low-fat diets and moving onto total parenteral nutrition, unless medically indicated otherwise.