Endoscopic Repair of Recurrent Tracheoesophageal Fistula With an Atrial Septal Occluder Device

Vivacqua, Alessandro; Malankar, Dhananjay; Idrees, Jay J.; Rice, Thomas W.; Raymond, Daniel P.; Roselli, Eric E.

doi:10.1016/j.athoracsur.2016.04.090

Cited by 11 publications

(12 citation statements)

References 6 publications

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“…[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. The AM-PLATZER TM vascular plug is indicated to embolize the vessels; however, similar with other septal occluders, it has been used for closure of GI fistula defects.…”

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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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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“…Successful treatment requires a multidisciplinary approach and specific course of action differs case by case. Although several reports of primary endoscopic treatment of BEF were published, first-line treatment remains surgical repair which results in excellent long-term outcomes and should be performed as soon as possible after diagnosis [3, 4]. The timing of the surgery is also given by the patient’s condition.…”

Section: Discussionmentioning

confidence: 99%

“…However, surgery is associated with the adverse events, of which the most feared one is a recurrence of the fistula. Any subsequent open repair with thoracotomy is technically challenging and implies a high risk of complications [3]. The incidence of recurrence after the primary surgery based on limited data is up to 10% [1–4].…”

Section: Introductionmentioning

confidence: 99%

Esophageal bypass surgery as a definitive repair of recurrent acquired benign bronchoesophageal fistula

Vachtenheim

Lischke

2019

J Cardiothorac Surg

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Background Acquired benign bronchoesophageal fistula (BEF) is rare and develops as a complication of other diseases, mostly of inflammatory processes and traumas of the chest. The treatment of choice is a surgical repair, which is considered definitive and leads to successful outcomes. However, incidence of recurrence after the primary repair based on limited data is up to 10% and its treatment is challenging. We report a surgical case of a patient with recurrent acquired benign BEF after primary resection and ensuing successful definitive repair with esophageal bypass surgery after temporary esophageal stenting. Case report A 46-year-old male was referred to our department with a symptomatic left-sided bronchoesophageal fistula as a complication of severe acute necrotizing mediastinitis that originated from odontogenic abscess. Previously, several cervicotomies and bilateral thoracotomy were performed at an external medical facility to manage the acute condition. We performed resection of the fistula through re-thoracotomy. Postprocedural esophagography demonstrated a recurrence of bronchoesophageal communication. Postinflammatory adhesions excluded further repair through thoracotomy, therefore a stent was introduced in the esophagus for 12 weeks. Thereafter, an esophageal bypass surgery using a substernaly interposed gastric conduit was performed and resulted in an excellent long-term outcome. Conclusions Esophageal bypass surgery using a substernaly interposed gastric conduit may be considered if the standard surgical repair of acquired benign bronchoesophageal fistula is not successful or feasible.

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“…Recently, an alternative repair technique using an atrial septal occlude device has also been shown to be effective. 3 When a TE fistula is suspected but cannot be located on bronchoscopy, performing upper endoscopy is the next logical mandatory step. Careful observation of the esophagus during upper endoscopy is always advised not to miss any important lesions such as TE fistula.…”

Section: Answer To: Image 4 (Page 362): Balloon Cuff Of a Tracheostommentioning

confidence: 99%

The Eye of a Stranger

Choe

Hyun

2017

Gastroenterology

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Endoscopic Repair of Recurrent Tracheoesophageal Fistula With an Atrial Septal Occluder Device

Cited by 11 publications

References 6 publications

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

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

Esophageal bypass surgery as a definitive repair of recurrent acquired benign bronchoesophageal fistula

The Eye of a Stranger

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