Successful treatment of chylothorax after esophagectomy using octreotide and etilefrine

Postoperative chylothorax is a rare, but serious complication after esophagectomy for esophageal cancer. Because the surgical treatment for chylothorax, which involves the ligation of the thoracic ducts, is not necessarily a reliable treatment, it is important to have alternative options for the con...

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Bibliographic Details
Published in:Esophagus : official journal of the Japan Esophageal Society 2016-07, Vol.13 (3), p.306-310
Main Authors: Tabata, Hirotaka, Ojima, Toshiyasu, Nakamori, Mikihito, Nakamura, Masaki, Katsuda, Masahiro, Hayata, Keiji, Matsumura, Shuichi, Kato, Tomoya, Kitadani, Junya, Takeuchi, Akihiro, Iwahashi, Makoto, Yamaue, Hiroki
Format: Article
Language:English
Subjects:
Case Report
Esophageal cancer
Esophagus
Gastroenterology
Gastrointestinal surgery
Medicine
Medicine & Public Health
Smooth muscle
Surgical Oncology
Thoracic Surgery
Throat surgery
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Summary:Postoperative chylothorax is a rare, but serious complication after esophagectomy for esophageal cancer. Because the surgical treatment for chylothorax, which involves the ligation of the thoracic ducts, is not necessarily a reliable treatment, it is important to have alternative options for the conservative treatment of chylothorax. We treated three patients with chylothorax after esophagectomy using a conservative treatment with administration of octreotide and etilefrine. Octreotide acts on lymph ductal endothelial cells with somatostatin receptors and reduces leakage of lymph fluids by contracting the smooth muscle of the lymph duct. Etilefrine contracts the smooth muscle, which decreases chyle flow output by reducing the diameter of the main lymph ducts. All three patients recovered fully without surgical treatment. We consider the combination of octreotide and etilefrine to be a safe and effective treatment for chylothorax after esophagectomy.
ISSN:1612-9059
1612-9067
DOI:10.1007/s10388-016-0526-8