713 The Role of Enteral Feed Composition on Chyle Leak Prevalence and Severity in Post-Oesophagectomy Patients

Abstract

Abstract Aim Chyle leak presents as an uncommon yet significant complication for post-oesophagectomy patients. This study aims to evaluate the role of enteral feed in the prevalence and severity of chyle leaks post-oesophagectomy. Method We identified 334 patients who underwent an open or minimally invasive oesophagectomy for oesophageal cancer at a single institution between 2015-2022. The prevalence, classification (ECCG scale) and respective management of chyle leaks were retrospectively recorded. Patients who had significant post-operative complications and did not start enteral feed on post-operative day 1 were excluded from the study. Results The median age at operation was 68 (31-82), of which 82% comprised of males. In patients who were started on Nutrison standard feed (high energy or high protein), 22% of patients developed a chyle leak (ECCG IA – IIB). In contrast, in patients who were initially started on Nutrison high energy and high protein feed (HEHP), 11% developed a chyle leak (ECCG IA-IIA). All cases were initially managed conservatively (ECCG I) with a success rate of 81%, before escalating to parenteral nutrition. Moreover, patients with a chyle leak demonstrated an increased length of stay (14.4±7.4 days) in comparison to patients without a chyle leak (12.3±8.7 days; p = 0.03). Conclusions The heterogenous management of post-oesophagectomy patients is heavily influenced by centre and surgeon-specific preferences. This study suggests a potential correlation between enteral feed composition and its role in preventing and minimizing chyle leaks following an oesophagectomy. Further prospective, multicentre studies are required to elucidate an optimal nutritional approach in managing post-oesophagectomy patients.