A Case of Post-Esophagectomy Chylothorax Successfully Treated with Octreotide after the Failure of Thoracic Duct Ligation in an Esophageal Cancer Patient

12 Citations 31 References
  • TAKAGI Makoto
    Department of Digestive Tract Surgery, Tokyo Medical University Hachiouji Medical Center
  • OKADA Ryosuke
    Department of Digestive Tract Surgery, Tokyo Medical University Hachiouji Medical Center
  • AOKI Toshiaki
    Department of Digestive Tract Surgery, Tokyo Medical University Hachiouji Medical Center
  • MATSUDA Daisuke
    Department of Digestive Tract Surgery, Tokyo Medical University Hachiouji Medical Center
  • YASUDA Yoshihiro
    Department of Digestive Tract Surgery, Tokyo Medical University Hachiouji Medical Center
  • LEE Jeong Sik
    Department of Digestive Tract Surgery, Tokyo Medical University Hachiouji Medical Center
  • SUZUKI Yoshiaki
    Department of Digestive Tract Surgery, Tokyo Medical University Hachiouji Medical Center
  • KATO Fumiaki
    Department of Digestive Tract Surgery, Tokyo Medical University Hachiouji Medical Center
  • SUMI Tetsuo
    Department of Digestive Tract Surgery, Tokyo Medical University Hachiouji Medical Center
  • AOKI Tatsuya
    Third Department of Surgery, Tokyo Medical University

Bibliographic Information

Other Title
  • オクトレオチドが有効であった食道癌術後乳糜胸の1例

Search this article

Description

The patient was a 42-year-old male. After preoperative chemotherapy and radiation therapy for esophageal cancer in the mid-thoracic region, subtotal esophagectomy with three-field lymph node dissection was performed via a right thoracolaparotomy (the thoracic duct was preserved). Chest tube drainage increased suddenly on postoperative day 3. On the postoperative day 4, enteral nutrition was instituted, and the drainage fluid turned cloudy white. A diagnosis of chylothorax was made, and since the total volume of drainage fluid measured 1,800ml and was affecting the patient's hemodynamics, surgery was performed. Ligation of the thoracic duct in the inferior mediastinum failed to stop the leakage from the superior mediastinum. The left superior mediastinum was therefore widened to localize the site of chyle leakage in the thoracic duct, and the duct was ligated distal to the site. The following day, however, a large volume of chyle again leaked from the drain, and intermittent subcutaneous ocreotide 50μg×3/day was instituted. On the second day of treatment, the drainage decreased markedly. Ocreotide was continued for a total of 8 days, gradually reducing the dose and then discontinued. It stopped the chyle leakage, and it became possible to discharge the patient. Chylothorax is a complication of esophagectomy that is difficult to manage. Intermittent subcutaneous ocreotide has no adverse effects and should be considered as a treatment option.

Journal

Citations (12)*help

See more

References(31)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top