EP69 -Treatment of chyle fistula after thyroid cancer surgery with octreotide

      Yoshida, Y.1; Horiuchi, K.1; Omi, Y.1; Tokumitsu, H.1; Nagai, E.1; Sakurai M.1; Haniu, K.1; Okamoto, T. 1 1 Department of Breast & Endocrine Surgery, Tokyo Women’s Medical University   Background/Purpose: Octreotide has been known to be effective in treating some patients with chyle leak after abdominal, thoracic or neck surgery. Its cure rate in the management of chyle fistula after thyroid cancer surgery, however, has rarely been reported. To determine the effectiveness of octreotide in the management of chyle fistula following lymph node dissection in patients with thyroid cancer. Methods: A retrospective study was conducted on 13 patients (male/female = 4/9) who were treated with octreotide for chyle fistula after lymph node dissection for papillary thyroid carcinoma between Aug 2012 and Jan 2017. Medical records were reviewed to collect following data: diagnosis of chyle leak, dose and duration of octreotide treatment, use of dietary modification, daily drain output, need for surgical management, and time to cure of chyle leak. Results: The median age was 51 (range 21-74) years old. Twelve patients underwent primary operation, and one patient received surgery for recurrent lymph node metastases. The median drain maximum output was 270 (124-1193) ml/day.  The combination of octreotide 300 microgram/day and diet modification resulted in cure of chyle leak in 12 patients (cure rate 92%, 95%CI: 64 -100%) with a median resolution time of 11 (range 8 – 31) days, while a revision surgery was needed in one patient after the conservative therapy for 17 days. Discussion & Conclusion: Octreotide was highly effective in the management of chyle fistula following lymph node dissection for thyroid cancer.


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