Endoscopic closure of acquired oesophagorespiratory fistulas with cardiac septal defect occluders or vascular plugs

Li, Jing; Gao, Xiaowen; Chen, Jingjing; Lao, Miaochan; Wang, Shushui; Zeng, Guohong

doi:10.1016/j.rmed.2015.04.014

Cited by 12 publications

(12 citation statements)

References 15 publications

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“…The other treatment option is endoscopic therapy, 28 which involves the use of an endo-stapler, histoacryl, clips, suturing, 29 or cardiac septal occluder device. 30,31 Although favorable short-term benefits for this approach have been reported, the long-term prognosis remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Bronchoesophageal fistula secondary to esophageal diverticulum in an adult: a case report and literature review

2021

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Esophageal diverticulum with secondary bronchoesophageal fistula is a rare clinical entity that manifests as respiratory infections, coughing during eating or drinking, hemoptysis, and sometimes fatal complications. In the present study, we describe a case of bronchoesophageal fistula emanating from esophageal diverticulum in a 45-year-old man who presented with bronchiectasis. We summarize the characteristics of this rare condition based on a review of the relevant literature.

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Section: Discussionmentioning

confidence: 99%

Bronchoesophageal fistula secondary to esophageal diverticulum in an adult: a case report and literature review

2021

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“…The other seven studies were excluded because they did not use ASD or VSD AMPLATZER TM occluder devices. [42][43][44][45][46][47][48] Li et al 42 conducted a case series on six patients with esophageal-respiratory fistulas (four benign and two malignant fistulas), used similar CSOs and a vessel plug (Lifetech Scientific Co., China), and presented a 100% immediate successful closure rate; however, four fistulas recanalized (two due to malignance). Two other studies 44,48 also used a similar ASD device (Gore, Flagstaff, AZ, USA) in patients with tracheoesophageal fistulas with successful closure.…”

Section: Discussionmentioning

confidence: 99%

Role of Cardiac Septal Occluders in the Treatment of Gastrointestinal Fistulas: A Systematic Review

et al. 2020

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Treating gastrointestinal (GI) fistulas endoscopically is challenging owing to an established epithelial tract. The variety of endoscopic approaches is transforming endoscopy into a first-line therapy. However, many sessions are often required, with variable success rates. Owing to these limitations, the off-label use of cardiac septal occluders (CSOs) has been reported. We searched for articles related to CSOs in the MEDLINE, EMBASE, Cochrane Library, and LILACS databases and gray literature. The primary outcomes included technical success, clinical success, and safety of CSOs in GI fistula management. A total of 25,574 records were identified, and 19 studies ultimately satisfied the inclusion criteria. Technical success was achieved in all cases. Of the 22 fistulas, 77.27% had successful closure, with a mean follow-up period of 32.02 weeks. The adverse event rate was 22.72%, with no associated mortality. Univariable and multivariable regression analyses showed no significant difference in the success of closure and adverse events in relation to several variables among the subgroups. The use of CSOs appeared to be technically feasible, effective, and safe in the treatment of GI fistulas. The satisfactory results derived from this sparse literature suggest that it can be an option in the management of GI fistulas.

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“…2 In addition, endoscopic closure using a variety of other methods has been reported, but with limited success, cardiac septal defect occluders, silicon rings, or vascular plugs have been reported to close the fistula. 13,14 Like interventional management, a plethora of approaches have been used to surgically correct acquired TEF; however, repair remains difficult, with complication rates reported up to 55% in large retrospective studies. 9,11 The most common approaches include initial cervical approach or cervical approach combined with a sternotomy for access, followed by tracheoesophageal repair.…”

Section: Discussionmentioning

confidence: 99%

Transverse Cervical Artery Flap Repair of Benign Acquired Tracheoesophageal Fistula

Artz

Yoo

Gilbert-Fernández

et al. 2019

J Reconstr Microsurg Open

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Acquired tracheoesophageal fistulas are rare but associated with significant morbidity and mortality. The majority of cases are due to prolonged or complicated endotracheal intubation, tracheostomy, or esophageal malignancy, or subsequent to radiation or chemotherapy for treatment of the latter. Other etiologies include esophageal stenting and complications secondary to endoscopic procedures. The pathophysiology involves chronic inflammation of the esophagus or posterior wall of the trachea, ultimately promoting fistulization between these two structures. Risk factors primarily depend on the etiology; however, excessive balloon pressures and prolonged intubation are among the strongest predictors of acquired tracheoesophageal fistula. In two reported cases, intubation with persistent air leaks resulted in fistulization. Patients present with refractory pneumonia, aspiration, hypoxemia, acute respiratory distress, enteral feed in endotracheal aspirate, or gastric distention following extubation. It can be difficult to distinguish normal functional deterioration from deterioration secondary to intubation. Up to 51% of patients intubated for at least 48 hours may experience dysphagia following extubation. Ultimately, the diagnostic algorithm includes an esophagogram, followed by imaging with computed tomography (CT) scan, and, more recently, CT scan with three-dimensional reconstructions, a bronchoscopy, and an esophagoscopy. Spontaneous closure rarely occurs, and the primary treatment modalities include interventional therapy with stenting via bronchoscopy, esophagoscopy, or surgical correction. Surgical intervention is associated with higher risks due to surrounding vital anatomy and, often, technical challenges requiring multispecialty care. Our case study presents a novel and effective method of repairing a benign acquired tracheoesophageal fistula utilizing the transverse cervical artery flap.

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Endoscopic closure of acquired oesophagorespiratory fistulas with cardiac septal defect occluders or vascular plugs

Abstract: Endoscopic closure of acquired ORFs with cardiac septal defect occluders or vascular plugs improve patients' general condition immediately after the procedure, but may result in recanalisation longterm. The occlusion might be considered an abridgement to surgery.

Cited by 12 publications

References 15 publications

Bronchoesophageal fistula secondary to esophageal diverticulum in an adult: a case report and literature review

Bronchoesophageal fistula secondary to esophageal diverticulum in an adult: a case report and literature review

Role of Cardiac Septal Occluders in the Treatment of Gastrointestinal Fistulas: A Systematic Review

Transverse Cervical Artery Flap Repair of Benign Acquired Tracheoesophageal Fistula

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