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Oral and Maxillofacial Surgery

Published in:

04-04-2023 | Neck Dissection | Review

Nutritional management of chyle leak after head and neck surgery: a systematic review and proposed protocol for management

Authors: Rebekah Smith, James Higginson, Omar Breik, Prav Praveen, Sat Parmar

Published in: Oral and Maxillofacial Surgery | Issue 1/2024

Abstract

Purpose

Chyle leaks are a rare complication of neck surgery causing local damage, impairing healing and compromising free flaps. High output leaks can result in electrolyte imbalances and malnutrition. Nutritional management such as restricting the absorption of triglycerides is believed to reduce chyle, allowing spontaneous resolution of a leak. Dietary preparations and management can aid in reducing chyle production. There are no clear guidelines to aid nutritional decision-making in this complex scenario.

Methods

A systematic review of the literature was carried out to identify studies evaluating nutritional management of chyle leaks in patients after neck dissections.

Results

Ten studies were identified evaluating the role of nutritional therapy in the management of patients with chyle leaks after neck dissections. The level of evidence was low. Several studies identified that low volume leaks (defined as < 1000 mls per day) often resolved by dietary management and other conservative measures. High volume leaks rarely resolved with conservative measures alone. Parenteral nutrition had an established role in this context.

Conclusions

There is limited evidence to guide dietary restriction and introduction of oral diet in patients with chyle leak after major head and neck surgery. Based on available evidence, local guidelines for the nutritional management of patients identified with a chyle leak were produced and adopted by the Trust and the head and neck MDT. A national database for voluntary contribution of prospective data would help to generate better quality management protocols.

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Title: Nutritional management of chyle leak after head and neck surgery: a systematic review and proposed protocol for management
Authors: Rebekah Smith
James Higginson
Omar Breik
Prav Praveen
Sat Parmar
Publication date: 04-04-2023
Publisher: Springer Berlin Heidelberg
Keyword: Neck Dissection
Published in: Oral and Maxillofacial Surgery / Issue 1/2024
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI: https://doi.org/10.1007/s10006-023-01152-8

2024 ASCO Annual Meeting

Springer Medicine

Nutritional management of chyle leak after head and neck surgery: a systematic review and proposed protocol for management

Abstract

Purpose

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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