Case of Recovery from Late Chylothorax after Surgery for Esophageal Cancer following Administration of Octreotide Acetate and Injection of OK-432 into the Pleural Cavity

Abstract

We report our experience of a case in which administration of octreotide acetate and injection of OK-432 into the pleural cavity proved effective for late chylothorax following surgery for esophageal cancer. The patient was a 54-year-old male diagnosed with progressive cancer C-T3N2(#7)M0 of the lower thoracic esophagus and given preoperative chemoradiotherapy in September 2004. Efficacy was assessed as PR, and in December the thoracic esophagus was excised completely via the right open thorax and lymphadenectomy of three sections was performed. Postoperative progress was favorable and the patient was discharged on day 32. On day 53 after surgery, bilateral pleural fluid was noted, and upon penetration of the pleural cavity, 3,000 ml of chylothoracic pleural fluid was recognized. The patient was admitted immediately and prohibited from eating a thoracic drain was implanted on the right side and octreotide acetate was administered daily. As it was found that drainage volume declined as a result, OK-432 10KE was injected into the pleural cavity. This enabled removal of the pleural drain, and the patient was discharged. This case suggests that octreotide acetate administration is a highly effective therapy against chylothorax.