A Case of Chylothorax following Resection of Esophageal Carcinoma Successful Treatment by Pleurodesis with OK-432 and Minocyclin

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  • OK-432とミノサイクリンの胸腔内投与が有効であった 食道癌切除後の乳糜胸の1例

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Abstract

We report a case of chylothorax following resection of esophageal carcinoma which was successfully treated with pleurodesis. A 62-year-old man was admitted to our hospital because of middle intrathoracic esophageal carcinoma. He underwent right thoracolaparotomy, esophagectomy, lymph node dissection, pyloroplasty and intrathoracic anastomosis. On and after the 1st postoperative day, more than l,400-2,000 m1/day of drainage continued through a chest tube. On the lOth day, the effusion became milky after oral ingestion ofice-cream. Lymphangiography showed an interruption of the medium flow at the level of Th10. So, we made a diagnosis of chylothorax. Conservative treatment with total parenteral nutrition and supplement of albumin did not decrease the volume of drainage. Therefore, pleurodesis with intrapleural infusion of OK-432 10KE and minocyclin 200 mg was carried ous for 3 days beginning on the 13th postoperative day. The treatment resulsed in a marked decrease in the drainage, and the chest tube was removed on the 18th day. The pleural effusion was almost resolved by the 55th day, and no symptoms such as dyspnea and chest pain were observed. We reviewed four cases of pleurodesis for chylothorax after resection of esophageal carcinoma. All the cases were treated successfully.

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