Successful treatment of chylothorax after esophagectomy using octreotide and etilefrine

Postoperative chylothorax is a rare, but serious complication after esophagectomy for esophageal cancer. Because the surgical treatment for chylothorax, which involves the ligation of the thoracic ducts, is not necessarily a reliable treatment, it is important to have alternative options for the conservative treatment of chylothorax. We treated three patients with chylothorax after esophagectomy using a conservative treatment with administration of octreotide and etilefrine. Octreotide acts on lymph ductal endothelial cells with somatostatin receptors and reduces leakage of lymph fluids by contracting the smooth muscle of the lymph duct. Etilefrine contracts the smooth muscle, which decreases chyle flow output by reducing the diameter of the main lymph ducts. All three patients recovered fully without surgical treatment. We consider the combination of octreotide and etilefrine to be a safe and effective treatment for chylothorax after esophagectomy.