Management of Nonmalignant Tracheo- and Bronchoesophageal Fistula after Esophagectomy.
Aged
Bronchial Fistula
/ diagnostic imaging
Bronchoscopy
/ adverse effects
Conservative Treatment
/ adverse effects
Esophageal Fistula
/ diagnostic imaging
Esophageal Neoplasms
/ surgery
Esophagectomy
/ adverse effects
Female
Humans
Male
Middle Aged
Reoperation
Retrospective Studies
Risk Factors
Stents
Suture Techniques
/ adverse effects
Time Factors
Tracheoesophageal Fistula
/ diagnostic imaging
Treatment Outcome
Journal
The Thoracic and cardiovascular surgeon
ISSN: 1439-1902
Titre abrégé: Thorac Cardiovasc Surg
Pays: Germany
ID NLM: 7903387
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
pubmed:
3
3
2020
medline:
20
5
2021
entrez:
2
3
2020
Statut:
ppublish
Résumé
Tracheo- or bronchoesophageal fistula (TBF) occurring after esophagectomy represent a rare but devastating complication. Management remains challenging and controversial. Therefore, the purpose of this study was to evaluate the outcome of different treatment approaches and to propose recommendations for the management of TBF. From 2008 to 2018, 15 patients were treated because of TBF and were analyzed with respect to fistula appearance, treatment strategy (stenting, endoscopic vacuum therapy and/or surgical reintervention) and outcome. In each case, the fistula was small, located close to the tracheal bifurcation and associated simultaneously ( Fistula appearance was similar in all patients. Implementation of esophageal stents cannot be recommended because of possibility of TBF at a later time point. Surgery is usually required and should preferably be performed when the patient's condition has been optimized at a single-stage repair. Esophageal diversion can only be recommended in patients with persisting mediastinitis. The key element for successful treatment of TBF, however, is control over sepsis; otherwise, outcome of TBF is devastating.
Sections du résumé
BACKGROUND
Tracheo- or bronchoesophageal fistula (TBF) occurring after esophagectomy represent a rare but devastating complication. Management remains challenging and controversial. Therefore, the purpose of this study was to evaluate the outcome of different treatment approaches and to propose recommendations for the management of TBF.
METHODS
From 2008 to 2018, 15 patients were treated because of TBF and were analyzed with respect to fistula appearance, treatment strategy (stenting, endoscopic vacuum therapy and/or surgical reintervention) and outcome.
RESULTS
In each case, the fistula was small, located close to the tracheal bifurcation and associated simultaneously (
CONCLUSION
Fistula appearance was similar in all patients. Implementation of esophageal stents cannot be recommended because of possibility of TBF at a later time point. Surgery is usually required and should preferably be performed when the patient's condition has been optimized at a single-stage repair. Esophageal diversion can only be recommended in patients with persisting mediastinitis. The key element for successful treatment of TBF, however, is control over sepsis; otherwise, outcome of TBF is devastating.
Identifiants
pubmed: 32114691
doi: 10.1055/s-0039-1700970
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
216-222Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
The authors have no conflict of interest.