116: INFLUENCE OF BODY COMPOSITE MEASURES ON CHYLE LEAK AFTER OESOPHAGECTOMY

• Published in: Diseases of the esophagus Vol. 35; no. Supplement_1
• Main Authors: Halle-Smith, J, Subramanya, M, Ghoneim, A, Almonib, A, Tan, B
• Format: Journal Article
• Language: English
• Published: 23.04.2022
• ISSN: 1120-8694; 1442-2050
• DOI: 10.1093/dote/doac015.116

Abstract Background and aim Chyle leak is an infrequent but potentially serious complication of oesophagectomy. Sarcopenia is an increasingly recognised prognostic factor in oesophageal cancer surgery. The aim of this study was to identify the influence of body composition and related factors on chyle leak following oesophagectomy. Methods Patients who developed chyle leak after oesophagectomy between January 2006–December 2020 were identified retrospectively from a prospectively collected and maintained dataset. A control group of patients undergoing oesophagectomy during the same time period was also collected. Relationships between chyle leak and demographics, operative factors and body composition measures were investigated as primary outcomes. Risk factors for severe chyle leak, defined as need for reintervention or greater than 1 litre of output per day, were evaluated as a secondary outcome. Results There were 26 patients who developed a chyle leak following an oesophagectomy. On univariate analysis, preoperative body mass index (BMI) (P = 0.001), subcutaneous fat index (P = 0.001) and total fat index (P = 0.004) were significantly associated with chyle leak. On multivariate analysis, a lower preoperative subcutaneous fat index was a significant independent predictor of chyle leak (P = 0.001). Sarcopenia was not found to be a significant predictor of developing chyle leaks. No significant predictors of severe chyle leak were identified. Conclusion A reduced preoperative body fat composition is a risk factor for chyle leak after oesophagectomy. Sarcopenia doesn’t predict either the occurrence or severity of chyle leak. This emphasises the importance of physiological and nutritional optimisation before oesophagectomy.