Successful Conservative Management of Benign Gastro-Bronchial Fistula After Intrathoracic Esophagogastrostomy

Bona, Davide; Sarli, Dario; Saino, Greta; Quarenghi, Matteo; Bonavina, Luigi

doi:10.1016/j.athoracsur.2007.04.043

Cited by 34 publications

(26 citation statements)

References 12 publications

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“…Gastric tube ulcer penetration into right pleural cavity, bronchi, pericardial cavity, cardiac left ventricular or atrial wall, thoracic aorta, pulmonary artery, left brachiocephalic vein, or sternum have been reported [5]. There are no reports of perforations cured by conservative follow-up with medication; therefore, surgical management or tracheal stenting is recommended [6][7][8]. In a previous study, Bona et al reported success in closing the gastrobronchial fi stula with bronchial stenting [6].…”

Section: Discussionmentioning

confidence: 95%

“…There are no reports of perforations cured by conservative follow-up with medication; therefore, surgical management or tracheal stenting is recommended [6][7][8]. In a previous study, Bona et al reported success in closing the gastrobronchial fi stula with bronchial stenting [6]. Tracheal stenting, however, may cause dislocation, incomplete closure of the fi stula, or diffi culty in spitting out sputum [9].…”

Section: Discussionmentioning

confidence: 96%

“…There is no evidence as to how often we should observe the gastric tube. Fistulas have occurred within 1 month according to one report [6]; however, more than 1 year had passed in other reports [5,10]. It is quite diffi cult to predict the time of the fi stula formation.…”

Section: Discussionmentioning

confidence: 99%

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A case of a gastrobronchial fistula after esophageal reconstruction successfully closed with an intercostal muscle flap

et al. 2009

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A case of a gastrobronchial fi stula after esophageal reconstruction successfully closed with an intercostal muscle fl ap Abstract A 63-year-old man with esophageal cancer underwent a subtotal esophagectomy via the thoracolaparotomy approach. Two years after the operation, a gastrobronchial fi stula unexpectedly occurred in the right bronchus. After admission, medication including omeprazole and nutritional support administered through an enteral tube improved his general condition, and the gastrobronchial fi stula was successfully closed with the seventh intercostal muscle fl ap. After the operation, sputa were aspirated with a bronchofi berscope through a tracheal incision rather than blindly with a catheter. He was in good condition 10 months after the operation.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 96%

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A case of a gastrobronchial fistula after esophageal reconstruction successfully closed with an intercostal muscle flap

et al. 2009

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“…The commonest mode of presentation is cough after swallowing, dyspnea, fever and recurrent pneumonia [7]. These are non-specific symptoms in the post-esophagectomy period.…”

Section: Discussionmentioning

confidence: 99%

Management of gastro-bronchial fistula complicating a subtotal esophagectomy: a case report

et al. 2009

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BackgroundThe development of a fistula between the tracheobronchial tree and the gastric conduit post esophagectomy is a rare and often fatal complication.Case presentationA 68 year old man underwent radical esophagectomy for esophageal adenocarcinoma. On postoperative day 14 the nasogastric drainage bag dramatically filled with air, without deterioration in respiratory function or progressive sepsis. A fiberoptic bronchoscopy was performed which demonstrated a gastro-bronchial fistula in the posterior aspect of the left main bronchus. He was managed conservatively with antibiotics, enteral nutrition via jejunostomy, and non-invasive respiratory support. A follow- up bronchoscopy 60 days after the diagnostic bronchoscopy, confirmed spontaneous closure of the fistulaConclusionsThis is the first such case where a conservative approach with no surgery or endoprosthesis resulted in a successful outcome, with fistula closure confirmed at subsequent bronchoscopy. Our experience would suggest that in very carefully selected cases where bronchopulmonary contamination from the fistula is minimal or absent, there is no associated inflammation of the tracheobronchial tree and the patient is stable from a respiratory point of view without evidence of sepsis, there may be a role for a trial of conservative management.

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“…Los stents esofágicos metálicos autoexpandibles o plás-ticos han sido empleados como tratamiento paliativo de fugas anastomóticas tras cirugía esofágica, roturas espontáneas esofágica s, síndromes de Boerhaave, ingestión de cuerpos extraños o tras procedimientos iatrogénicos que provoquen la erosión de la pared del esófago 24 . Los pacientes con FAE, además del control de la hemorragia , precisan el tratamiento de la mediastinitis concomitante que se produce 1,4 .…”

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Fístula aortoesofágica secundaria a endoprótesis torácica: a propósito de 3 casos y revisión de la literatura

et al. 2013

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Recibido el 29 de septiembre de 2012; aceptado el 4 de enero de 2013 Disponible en Internet el 15 de marzo de 2013 PALABRAS CLAVE Fístula aortoesofágica; Procedimiento endovascular; Aorta torácica; Perforación esofágica; CirugíaResumen La reparación endovascular de aorta torácica (TEVAR) es una modalidad mínima-mente invasiva y generalmente excelente de tratar aneurismas torácicos, disecciones o roturas aórticas postraumáticas. La fístula aortoesofágica (FAE) es una causa altamente letal de sangrado masivo y constituye una complicación catastrófica tras una TEVAR. La incidencia de FAE tras TEVAR ha sido situada entre el 5 y el 10,53%. En este artículo aportamos 3 casos de de FAE tras TEVAR y nuestra experiencia en el tratamiento de las mismas. Se incluye además una revisión de la literatura disponible. Estos hallazgos enfatizan la importancia de la infección mediastínica, el tratamiento quirúrgico del esófago y el reemplazamiento de la aorta. El tratamiento debe ser quirúrgico, puesto que las estrategias conservadoras han demostrado un desenlace casi invariablemente fatal. Futuros desarrollos en el diseño de las endoprótesis y los materiales, así como el evitar un sobredimensionamiento excesivo, pueden reducir la aparición de esta desastrosa complicación. Aortoesophageal fistula secondary to a thoracic endoprosthesis: A presentation of 3 cases and a review of the literatureAbstract Thoracic endovascular aortic repair (TEVAR) is a minimally invasive, and generally excellent, technique to treat thoracic aortic aneurysms, dissections, or traumatic aortic transections. Aortoesophageal fistula (AEF) is a highly lethal cause of massive bleeding and a catastrophic complication after TEVAR. The incidence of AEF after TEVAR has been reported as between 5% and 10.53%. We present 3 cases of AEF after TEVAR, and our experience with management and outcome of these patients. A review of the recent literature has been included. These findings emphasize the importance of mediastinal infection, esophageal surgical management, and aorta replacement. Management should be surgical, since the outcome under * Autor para correspondencia. Correo electrónico: esannorberto@hotmail.com (E.M. San Norberto).

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Successful Conservative Management of Benign Gastro-Bronchial Fistula After Intrathoracic Esophagogastrostomy

Cited by 34 publications

References 12 publications

A case of a gastrobronchial fistula after esophageal reconstruction successfully closed with an intercostal muscle flap

A case of a gastrobronchial fistula after esophageal reconstruction successfully closed with an intercostal muscle flap

Management of gastro-bronchial fistula complicating a subtotal esophagectomy: a case report

Fístula aortoesofágica secundaria a endoprótesis torácica: a propósito de 3 casos y revisión de la literatura

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