MCT Enteral Feeding to Reduce Chyle Leak After Oesophagectomy

Summary

Chyle leak (chylothorax) is a recognised complication following minimally invasive oesophagectomy for oesophageal cancer and may result in prolonged hospital stay, nutritional compromise, and need for additional interventions. Medium-chain triglyceride (MCT) feeds reduce lymphatic flow as they are absorbed directly via the portal circulation rather than through the thoracic duct. While MCT feeds are commonly used in the management of established chyle leaks, their role in prevention has not been evaluated in a randomised controlled trial. This single-centre randomised controlled trial will evaluate whether initiating postoperative jejunostomy feeding with MCT-based enteral nutrition reduces the incidence of clinically and biochemically confirmed chyle leak compared with standard enteral feeding in patients undergoing minimally invasive or robotic-assisted oesophagectomy. Participants will be randomised in a 1:1 ratio to receive either MCT-based feeds or standard jejunostomy feeds starting on postoperative day 1. The primary outcome is the incidence of chylothorax. Secondary outcomes include chest drain output, re-intervention rates, and length of hospital stay.

Eligibility

Inclusion Criteria:

* Age ≥ 18 years
* Diagnosis of oesophageal cancer (adenocarcinoma or squamous cell carcinoma)
* Planned minimally invasive or robotic-assisted oesophagectomy (MIO or RAMIO) with curative intent
* Placement of feeding jejunostomy at or prior to oesophagectomy
* Able to provide written informed consent

Exclusion Criteria:

* Inability to provide informed consent
* No feeding jejunostomy placed at or prior to surgery
* Prior or concomitant malignancy that would interfere with study protocol or outcomes

Conditions2

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