SRS66 - Chyle leak after colorectal resection: a systematic review and meta-analysis

Abstract Objective To systematically review and synthesize existing literature on the incidence, clinical presentation, management, and outcomes of chyle leak following colorectal surgery. Methods A systematic review and meta-analysis were conducted using data from 20 studies across 10 countries. The studies encompassed a total of 33 504 patients undergoing colorectal resection, among whom 1446 cases of chyle leak were reported. Various study designs were included, predominantly retrospective cohort studies. Data were extracted on incidence, site of lymphatic injury, hospital stay duration, time to resolution, complications, readmissions, recurrence, and mortality. Results The pooled incidence of chyle leak was approximately 4.3%. Most leaks were detected during the initial hospital stay, with a minority presenting on readmission. Management was largely conservative, with most cases resolving within 7–10 days. Unplanned readmissions were infrequently reported. There were no reported mortalities directly attributable to chyle leak across all included studies. Recurrence was rare and typically managed with drain reinsertion or conservative measures. Conclusions Chyle leak post-colorectal resection, while uncommon, carries clinical significance due to its association with increased postoperative burden. Despite this, outcomes remain favorable with appropriate conservative management. These findings highlight the importance of early detection and standardized management protocols to minimize morbidity and optimize recovery.