Preoperative Administration of Olive Oil Reduces Chylothorax After Minimally Invasive Esophagectomy

Abstract

Background. Chylothorax after esophagectomy is uncommon but potentially fatal. We performed a retrospective study to assess the effect of olive oil administered orally before surgery on reducing chylothorax in patients who underwent minimal invasive esophagectomy.Methods. Between May 2013 and December 2016, patients with esophageal squamous cell cancer who underwent minimal invasive esophagectomy were screened. Patients in the investigational group were preoperatively administered olive oil orally 8 hours before surgery, and patients in the control arm received no olive oil. We used a propensity score matching model to derive 1:1 cohorts. Statistical analysis was performed by using the t test or c 2 or Fisher's exact test.Results. The propensity score matching model finally selected 384 of 425 patients, with 192 patients in each Patients and Methods Patient PopulationThis was a retrospective study. Approval from the Ethics Committees of the Shantou Central Hospital was obtained for the use of all the medical records. All patients provided written consent before the operation. The committee approved all protocols. The methods were performed in accordance with the approved guidelines. Patients were staged according to the American Joint Committee on Cancer TNM clinical stage classification (2002).

Safety and Efficacy of Minimally Invasive McKeown Esophagectomy in 1023 Consecutive Esophageal Cancer Patients: A Single-Center Experience

“…According to our experience, routine thoracic duct ligation was recommended for middle or upper esophageal cancer with T3-T4, and should be performed when thoracic duct was damaged de nitely or suspiciously. In addition, several studies found that preoperative oral administration of olive oil can effectively pevent chylothorax [31,32].…”

Association between low-fat enteral nutrition after esophagectomy and a lower incidence of chyle leakage: A call for more and better evidence

“…20 Oral administration of olive oil 8 hours before esophagectomy might also be effective to minimize postoperative chylothorax. 21 Similarly, preoperative oral administration of milk facilitates visualization of the thoracic duct and decreases the risk of iatrogenic injury during esophagectomy. 22 Preventive octreotide was not associated with a reduced risk of chylothorax after mediastinal lymph node dissection.…”

Fluorescence‐guided cancer surgery—A new paradigm

“…60,61 However, the contrast provided is low with poor reproducibility. 62 NIR-ICG technique is an important clinical tool for intraoperative assessment of unidentified TD injury providing a precise method for identification of chyle leakage site with excellent sensitivity and specificity. Additionally, it provides real-time visual confirmation of the stoppage of the leak, seen as the accumulation of green fluorescence at the site of ligation/clipping.…”