Abstract
Post-operative lymphorrhea resulting from thoracic duct injury is a possible complication of esophagectomy for carcinoma. Management of such conditions includes conservative methods and surgery. Recently, the usefulness of octreotide for refractory lymphorrhea has been reported. On the other hand, octreotide monotherapy has been reported to be ineffective in some cases. We therefore attempted combination therapy with octreotide and etilefrine.
We have report a case of a 68-year-old man who underwent esophagectomy for recurrent oropharyngeal carcinoma and subsequently developed persistent postoperative chylothorax and chyloperitoneum. Continuous drainage and conventional conservative management could not resolve the problem. Successful treatment was achieved using subcutaneous octreotide injection and intravenous etilefrine infusion. These medications were able to cause smooth muscle contraction in the thoracic duct wall, and also to reduce chyle flow. This therapy allowed resolution of chyle flow within a few days without any adverse side-effects. From this experience, we believe that the combination therapy with octreotide and etilefrine warrants consideration as one potential method for managing post-operative lymphorrhea.
