Table 1 .

Characteristics of included studies

Study	Design	Operation type	Total index operations	Total chyle leak	Mean age (years)	Management
Milito et al 202031	RCS	TTE	992	50	68	Surgical management if >1,000ml in 24h for >48h despite maximal conservative management
Alamdari et al 201825	RCT	THE	Not stated	98	59	Two weeks conservative and then randomised to surgery or platelet-rich fibrin glue pleurodesis
Weijs et al 201720	RCS	MIE, robotic and open	371	76	64	Volume-guided step-up management pathway
Brinkmann et al 201633	RCS	Ivor Lewis	906	17	68.7	Two days’ conservative management then early re-thoracotomy
Abe et al 201626	RCS	Open subtotal	542	9	68	Pedal or intranodal lymphangiography followed by conservative, pleurodesis or VATS
Gupta et al 201534	RCS	THE, MIE, TTE	45	4	56.25	Conservative management then reoperation at a minimum of 3 days postoperatively
Miao et al 201532	RCS	Ivor Lewis	1,290	34	60	Conservative management followed by re-thoracotomy at minimum 3 days postoperatively
Marthaller et al 201524	RCS	Ivor Lewis, THE, Distal	Not stated	5	66.6	Percutaneous thoracic duct embolisation
Kim et al 201429	RCS	Ivor Lewis	1,514	57	62.7	Conservative management, then octreotide or pleurodesis, then surgery
Fujita and Daiko 201413	RCS		521	20		Before-and-after study of normal conservative management vs octreotide enhanced management. Surgery for treatment failure
Li et al 201321	RCS	Open	10,574	306	58	2-day vs 2-week conservative management protocol followed by surgery if not resolved
Shah et al 201228	RCS	Multiple	892	34	67.5	Variable conservative management followed by surgery
Hayden et al 200727	RCS	Multiple	129	6	58	Immediate minimally invasive thoracoscopy
Schumacher et al 200735	RCS	Ivor Lewis, THE	409	10	61	Conservative or immediate surgical
Lagarde et al 20055	RCS	TTE, THE	536	21	62	Conservative management followed by surgery
Rao et al 200430	RCS	Multiple	520	14	49	Conservative followed by surgery
Bonavina et al 200136	RCS	Ivor Lewis	316	3	56-63	Conservative followed by surgery
Merigliano et al 200019	RCS	Multiple	1,787	19	57	Pre- and post study of conservative management vs immediate operative
Alexiou et al 199837	RCS		523	21	64.7	Conservative management and then clinical decision to operate
Dugue et al 199838	RCS	Ivor Lewis	850	23	54	Conservative management for 12 days and reoperate if output >500ml
Bolger et al 199139	RCS	Multiple	537	11		Conservative management with clinical decision to operate
			23,254	838 (<3.6%)

MIE, minimally invasive oesophagectomy; RCS, retrospective cohort study; RCT, randomised controlled trial; THE, transhiatal oesophagectomy; TTE, transthoracic oesophagectomy; VATS, video-assisted thoracoscopic surgery.