Adequate Management of Postoperative Complications after Esophagectomy: A Cornerstone for a Positive Outcome

Kamaleddine, Imad; Hendricks, Alexander; Popova, Magdalena; Schafmayer, Clemens

doi:10.3390/cancers14225556

Cited by 3 publications

(1 citation statement)

References 111 publications

(134 reference statements)

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“…Following our protocol (Fig. 1 ) [ 4 ], an upper gastrointestinal tract endoscopy was performed under sedation with Propofol. It showed the presence of a fibrin coat at the anastomotic level with an indirect sign of AL when the Easy-Flow drain bag was filled with air.…”

Section: Case Reportmentioning

confidence: 99%

Endoscopic Vacuum Therapy for Treating an Esophago-Pulmonary Fistula after Esophagectomy: A Case Report and Review of the Literature

Kamaleddine¹,

Popova²,

Alwali³

et al. 2023

Visc Med

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An acquired esophago-respiratory fistula represents an abnormal connection between the esophagus and the respiratory system. It is usually caused by malignancy and infection, or it occurs as a complication after surgery or radiation therapy. It can be divided according to its anatomical level into esophago-tracheal fistula, esophago-bronchial fistula, and in the rarest case, esophago-pulmonary fistula (EPF). We present a case of EPF aggravating an anastomotic leak (AL) after the Ivor-Lewis operation for esophageal cancer. The leak was treated with endoscopic vacuum therapy (EVT) using the Eso-Sponge® system (B. Braun Melsungen AG, Melsungen, Germany). In the further course of treatment, an EPF was suspected by a new onset of severe cough after oral fluid intake. The suspicion was confirmed by injecting methylene blue dye into the paraesophageal-extraluminal cavity during endoscopy and attesting to its presence in the respiratory tract by simultaneous bronchoscopy. Furthermore, an oral contrast computed tomography scan showed the presence of contrast in the right lower lobe of the lung. This complication was treated conservatively with EVT and antibiotics. Nutrition was administered through the existing jejunostomy. Both fistulas and the paraesophageal cavity were fully healed, oral intake was maintained, and the patient was discharged. This rare life-threatening complication can be treated conservatively. Its management is challenging, controversial, and lacks a general consensus.

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Section: Case Reportmentioning

confidence: 99%