Lei Yiyan, Feng Yanfen, Zeng Bo, Zhang Xin, Chen Jingfu, Zou Jianyong, Su Chunhua, Liu Zhenguo, Luo Honghe, Zhang Shuishen
Department of Thoracic Surgery, Sun Yat-sen University, the First Affiliated Hospital, Guangzhou, Guangdong, P. R. China.
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P. R. China.
Thorac Cardiovasc Surg. 2018 Aug;66(5):370-375. doi: 10.1055/s-0037-1602259. Epub 2017 May 2.
There is no consensus on the effectiveness of prophylactic thoracic duct ligation (PLG) in esophagectomy for reducing the incidence of postoperative chylothorax. We performed a systemic review and meta-analysis to study its efficacy.
A systemic review of the publications was performed on three databases to identify all the relevant literature on comparative outcomes of PLG and nonprophylactic thoracic duct ligation (NPLG). The primary end point was the incidence of postoperative chylothorax.
Seven studies with comparative data on PLG ( = 2,178) versus NPLG ( = 3,048) were identify from the current publications. Comparison showed no significant difference between PLG and NPLG on the incidence of postoperative chylothorax (relative risk = 0.431; 95% confidence interval, 0.186 to 1.002; = 0.050).
Although some studies showed that PLG during the esophagectomy was effective to lower the incidence of postoperative chylothorax, no evidence was observed in the present meta-analysis. Further research is warranted to validate the findings.
对于预防性胸导管结扎术（PLG）在食管癌切除术中降低术后乳糜胸发生率的有效性，目前尚无共识。我们进行了一项系统评价和荟萃分析以研究其疗效。
对三个数据库中的出版物进行系统评价，以识别所有关于PLG与非预防性胸导管结扎术（NPLG）比较结果的相关文献。主要终点是术后乳糜胸的发生率。
从当前出版物中识别出七项具有PLG（n = 2178）与NPLG（n = 3048）比较数据的研究。比较显示PLG与NPLG在术后乳糜胸发生率上无显著差异（相对风险 = 0.431；95%置信区间，0.186至1.002；P = 0.050）。
尽管一些研究表明食管癌切除术中的PLG可有效降低术后乳糜胸的发生率，但在本荟萃分析中未观察到相关证据。有必要进行进一步研究以验证这些发现。
