New combined medical treatment with etilefrine and octreotide for chylothorax after esophagectomy a case report and review of the literature

Yu Ohkura, Masaki Ueno, Toshiro Iizuka, Shusuke Haruta, Tsuyoshi Tanaka, Harushi Udagawa

研究成果: Article査読

13 被引用数 (Scopus)

抄録

Postoperative chylothorax is a rare but well-known complication of general thoracic surgery. Medical treatment of chylothorax was reported in the past, but there is still considerable controversy on the appropriate management strategies. Two patients with esophageal cancer underwent esophagectomy, 2-field lymph node dissection, and resection of thoracic duct together with ileocolic reconstruction via the retrosternal route at our hospital. Chylothorax developed on the 32nd postoperative day (POD) in 1 patient and the 12th POD in the other, manifesting as a change in the character of thoracic drainage to turbid white. Both were immediately started on octreotide (300mg/day) and etilefrine (120 mg/day). When the amount of pleural effusion decreased to <50 mL/day, we performed pleurodesis with Picibanil (OK432). Thereafter, the patients gradually made satisfactory progress and resumed oral food intake, and the thoracotomy tubes were eventually removed. They have remained recurrence-free at the time of writing. In this report, we demonstrated the clinical efficacy of etilefrine for the management of postesophagectomy chylothorax. New medical treatment options for this condition are now broad and the usefulness of combined therapy consisting of a sclerosing agent, etilefrine, and octreotide is underscored, regardless of the status of the thoracic duct.

本文言語English
論文番号e2214
ジャーナルMedicine (United States)
94
49
DOI
出版ステータスPublished - 2015
外部発表はい

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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