Somatostatin analogue treatment of cervical lymphorrhea after neck dissection

Tanaka Kentarou, Daiko Hiroyuki, Sakuraba Minoru, Hayashi Ryuichi

doi:10.5981/jjhnc.34.568

Background: The first choice of treatment for cervical lymphorrhea after lymph node dissection is conservative therapy, such as local compression, non-fat food, or nothing per os. When conservative treatment fails, surgical procedures are considered. However, some cases of persistent lymphorrhea are difficult to control. In general surgery, a somatostatin analogue is sometimes used to treat lymphorrhea or chylothorax. Methods: From January 2005 through December 2006, we used a somatostatin analogue (Sandostatin®) to treat 8 cases of intractable cervical lymphorrhea that developed after neck dissection and resection of head and neck cancers. The somatostatin analogue was administered through hypodermic injection at a dosage of 200 to 300μg/day for 3 to 7 days. Results: Treatment with the somatostatin analogue successfully halted the cervical lymphorrhea after 5 days in 2 cases and after 9 days in 2 cases but was not effective in the other 4 cases. No adverse effects were observed. Conclusion: There have been few reports about the use of somatostatin analogue for cervical lymphorrhea, and the present report is, to our knowledge, the first of somatostatin analogue treatment in head and neck surgery. In this series, the cure rate was 50% and the treatment was considered effective for cervical lymphorrhea. Although treatment criteria and standard dosages have not been established, we believe somatostatin analogues should be considered in cases of intractable cervical lymphorrhea.

Somatostatin analogue treatment of cervical lymphorrhea after neck dissection

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