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A systematic review of English and non-English articles using OVID MEDLINE (1980–2014) was performed to evaluate the potential value of prophylactic ligation of the thoracic duct in preventing chylous leakage after oesophagectomy for cancer. Search terms included [Oesophagectomy OR esophagectomy] AND [chylothorax] AND [thoracic duct ligation]. Only those papers that directly compared the incidence of chylothorax in patients who underwent prophylactic ligation [ligation group (LG)] with that in those who had conservative treatment were selected [preservation group (PG)]; all the articles presenting original data and supplying sufficient information on the chylothorax rate after oesophagectomy were included. Independent extraction of articles was performed by two authors using predefined data fields, including study quality indicators. The PRISMA guidelines were carefully adhered to. A total of 5254 …