Gastrobronchial fistula following minimally invasive esophagectomy for esophageal cancer in a patient with myotonic dystrophy: Case report

Hugin, Silje; Johnson, Egil; Johannessen, Hans-Olaf; Hofstad, Bjørn; Olafsen, Kjell; Mellem, H

doi:10.1016/j.ijscr.2015.10.023

Cited by 3 publications

(5 citation statements)

References 17 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Conservative treatment is also a possible option. Hugin et al 15 reported on the successful cure of a gastrobronchial fistula between the right intermediary bronchus and the esophagogastric anastomosis using ventilation maintained at low airway pressures, combined with a partially covered wall flex stent placed in the esophageal and gastric remnant. Non-surgical treatment could effectively occlude the fistula and act as a bridge treatment, and the application of a tracheal stent could improve the patient's general condition before the trachea is suitable for surgical repair.…”

Section: Discussionmentioning

confidence: 99%

Management of thoracogastric airway fistula after esophagectomy for esophageal cancer: A systematic literature review

Wang

Chen

et al. 2020

J Int Med Res

View full text Add to dashboard Cite

Background Thoracogastric airway fistula (TGAF) is a serious complication of esophagectomy for esophageal cancer. We conducted a systematic review of the appropriate therapeutic options for acquired TGAF. Methods We performed a literature search to identify relevant studies from PubMed, EMBASE, and Web of Science using the search terms “gastric airway fistula”, “gastrotracheal fistula”, “gastrobronchial fistula”, “tracheogastric fistula”, “bronchogastric fistula”, “esophageal cancer”, and “esophagectomy”. Result Twenty-four studies (89 patients) were selected for analysis. Cough was the main clinical presentation of TGAF. The main bronchus was the most common place for fistulas (53/89), and 29 fistulas occurred in the trachea. Almost 73% (65/89) of patients underwent non-surgical treatment of whom 87.7% (57/65) received initial fistula closure. Twenty-three patients underwent surgery, including 19 (82.6%) with initial closure. The 1-, 2-, 3-, 6-, and 9-month survival rates in patients who underwent surgical repair were 95.65%, 95.65%, 82.61%, 72.73%, and 38.10%, respectively, and the equivalent survival rates in patients with tracheal stent placement were 91.67%, 86.67%, 71.67%, 36.96%, and 13.33%, respectively. Conclusion TGAF should be suspected in patients with persistent cough, especially in a recumbent position or associated with food intake. Individualized treatment should be emphasized based on the general condition of each patient.

show abstract

Section: Discussionmentioning

confidence: 99%

Management of thoracogastric airway fistula after esophagectomy for esophageal cancer: A systematic literature review

Wang

Chen

et al. 2020

J Int Med Res

View full text Add to dashboard Cite

show abstract

“…Two patients with type II AGF were healed. Some authors claim that the patients with AGF can benefit from early stent placement (10)(11)(12)25). However, based on the results from a Mantel-Haenszel analysis, Boyd concluded that though airway stenting for AGF was associated with an initial closure rate of 75%, there was a high recurrence rate of 39%.…”

Section: Discussionmentioning

confidence: 99%

“…The literature are comprised mainly case reports, and, as a consequence, there is no ideal therapeutic principle that can be recommend. General conservative treatments include jejunostomy feeding, fasting, the administration of proton pump inhibitors and NGT drainage (7), bronchoscopy (8)(9)(10)(11) or gastroscopy (12) and stent insertion. These treatments have shown to achieve reliable good results in several studies.…”

Section: Introductionmentioning

confidence: 99%

The classification and treatment strategies of post-esophagectomy airway-gastric fistula

Wang

Yang

et al. 2020

J Thorac Dis

View full text Add to dashboard Cite

Background: Airway-gastric fistulas (AGFs) are rare but life-threatening complications after esophagectomy for esophageal cancer. Their effective and reasonable management is challenging and still controversial. This study reports the classification and management strategies of post-esophagectomy AGF based on a retrospective analysis of 26 cases in two large volume centers in China. Methods: Between January 2000 and December 2017, 6,316 consecutive patients with esophageal carcinoma underwent esophagectomy. AGF was verified in 26 patients. The patients with AGF were divided into two types based on the anatomic characteristics of the fistula. Type I was characterized by the presence of fistula orifices in digestive tract that were higher than those in the airway and were treated with conservative management. Type II had both fistula orifices located on the same horizontal plane and were treated with surgical management. Pearson Chi-Square (R software) was used to compare mortality rates. Results: From January 2000 and December 2017, 26 cases occurred AGF in 6,316 consecutive patients with esophageal carcinoma underwent esophagectomy and the incidence of AGF was 0.4%. Ten of 12 patients with type I AGF survived. Nine of 14 patients with type II AGF died. There was a significantly difference in the mortality rates between patients with AGF type I and II, which was 16.7% (2/12) and 64.3% (9/14) (χ 2 =6.003, P=0.014), respectively. Conclusions: AGF may be classified into two types according to the anatomic characteristics. Type I patients may be cured by conservative management and type II patients, require surgical intervention with pedicled tissues flap wrapping of the airway.

show abstract

“…Management is patient-tailored and depends on several factors such as the clinical status, blood supply of the gastric conduit and fistula characteristics (cause, dimensions, site) 2 11. The vast majority of cases require a one- or two-stage surgical intervention 11 21. The most widespread approach is a one-stage procedure and consists of direct fistula dissection and closure of the underlying gastric and bronchial defect, with or without vital tissue interposition 11.…”

Section: Discussionmentioning

confidence: 99%

“…In the specific circumstances of GBFs, conservative management is seldom feasible 19. To date, only five cases with conservative management, although with variable success, have been reported 2 12 17 18 21 22…”

Section: Discussionmentioning

confidence: 99%

Benign gastrobronchial fistula following oesophagectomy in a patient presenting with respiratory failure

et al. 2019

View full text Add to dashboard Cite

Benign gastrobronchial fistula (GBF) is a rare but potentially life-threatening complication of oesophagectomy for malignancy. We present a case of GBF post Ivor-Lewis surgery manifesting as pulmonary sepsis and type II respiratory failure. Clues to the diagnosis were persistent hypercapnia despite high minute ventilation, aspiration of gastric content through the endotracheal tube and accumulation of air in the nasogastric drainage bag. Flexible bronchoscopy confirmed the diagnosis. Surgical exploration identified necrosis of the proximal stomach as causative factor. Despite reconstruction of the oesophagogastric anastomosis and interposition of an intercostal muscle flap, the patient developed a new episode of type II respiratory failure. Bronchoscopy revealed in situ recurrence of the fistula. Patency of the fistula was proven through application of methylene blue with subsequent gastroscopy. A conservative, symptom-based, management was conducted. The patient died 6 hours later.

show abstract

Gastrobronchial fistula following minimally invasive esophagectomy for esophageal cancer in a patient with myotonic dystrophy: Case report

Cited by 3 publications

References 17 publications

Management of thoracogastric airway fistula after esophagectomy for esophageal cancer: A systematic literature review

Management of thoracogastric airway fistula after esophagectomy for esophageal cancer: A systematic literature review

The classification and treatment strategies of post-esophagectomy airway-gastric fistula

Benign gastrobronchial fistula following oesophagectomy in a patient presenting with respiratory failure

Contact Info

Product

Resources

About