Abstract
The patient was a 72-year-old woman who underwent thoracoscopic subtotal esophagectomy for esophageal cancer in the mid-thoracic region. The thoracic duct was preserved. On postoperative day (POD) 2, enteral nutrition was initiated. On the following day, pleural effusion drainage markedly increased. On POD 4, the fluid in the chest tube turned into a milky appearance and the patient was diagnosed with chylothorax. Enteral nutrition was changed to total parenteral nutrition, but the drainage volume was not decreased. From POD 7, octreotide acetate was administered, but it was not so effective. The patient's general condition was stable and a CT scan of the chest revealed a thrombus in the superior vena cave, so conservative therapy was consistently performed. Finally, etilefrine infusion was started on POD 28, then the drainage gradually decreased. The chest tube was removed on POD 54 after we confirmed that discontinuation of etilefrine did not increase the drainage. Chylothorax is a relatively rare complication of esophagectomy that is difficult to manage. Etilefrine may be an effective and safe therapeutic modality for treating chylothorax after surgery for esophageal cancer, though few cases have been reported.
