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2015 | 86 | 11 | 537-539
Tytuł artykułu

Successful Endoscopic Treatment of a Postoperative Tracheomediastinal Fistula Caused by Anastomotic Insufficiency after Esophageal Resection with Fibrin Glue

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Fistula development after esophageal resection is considered as one of the most serious postoperative complications. The authors reported a case on clinical experiences in the postoperative diagnostic and successful therapeutic management of a tracheomediastinal fistula after esophageal resection, using endoscopic application of fibrin glue. The early approach of an anastomotic insufficiency after esophageal resection because of a squamous cell carcinoma (pT3pN0M0G2) below the tracheal bifurcation including transposition of a re-modelled gastric tube and end-to-side anastomosis 24 hours postoperatively in a 55-year old patient combined i) surgical re-intervention from the periesophageal site (reanastomosis, gastroplication, lavage, local and mediastinal drainage) and, later on, ii) extensive rinsing with consecutive endoscopic fibrin glue application into the tracheal mouth of the subsequently developed tracheomediastinal fistula as a consequence of the inflammatory changes within the surrounding tissue. In conclusion, this approach was successful and beneficial for the patient's further postoperative course, which was associated with other complications such as pneumonia and acute myocardial infarction. The fistula closed sufficiently and permanently with no further surgical intervention at the tracheal as well as mediastinal site and allowed patient's later discharge with no further complaints or problems.
Wydawca

Rocznik
Tom
86
Numer
11
Strony
537-539
Opis fizyczny
Daty
otrzymano
2013-12-15
online
2015-02-03
Twórcy
  • Department of Anesthesiology and Intensive Care, Municipal Hospital, Magdeburg, Germany
autor
  • Department of General, Abdominal and Vascular Surgery, University Hospital in Magdeburg, Germany
autor
  • Department of General, Abdominal and Vascular Surgery, University Hospital in Magdeburg, Germany
  • Division of Pulmonology, Department of Cardiology, Pulmonology and Angiology, University Hospital in Magdeburg, Germany
autor
  • Department of General, Abdominal and Vascular Surgery, University Hospital in Magdeburg, Germany, frank.meyer@med.ovgu.de
Bibliografia
  • 1. Huttl TP, Wichmann MW, Geiger TK et al.: Techniques and results of esohageal cancer surgery in Germany. Langenbecks Arch Surg 2002; 387: 125-29.
  • 2. Ussat S, Lodes U, Wex C et al.: Successful closure of a postoperative esophagobronchial fistula following esophageal resection using fibrin glue. Dtsch Med Wochenschr 2013; 138(27): 1406-09.[WoS]
  • 3. Belleguic C, Lena H, Briens E et al.: Tracheobronchial Stenting in Patients with Esophageal Cancer Involving the Central Airways. Endoscopy 1999; 03: 232-36.[Crossref]
  • 4. Doniec JM, Schniewind B, Kahlke V et al.: Therapy of Anastomotic Leaks by Means of Covered Self-Expanding Metallic Stents after Esophagogastrectomy. Endoscopy 2003; 08: 652-58.
  • 5. Andreetti c, ďAndrilli A, Ibrahim M et al.: Effective treatment of post-pneumonectomy bronchopleural fistula by conical fully covered self-expandable stent. Interact Cardiovasc Thorac Surg 2012; 14(4): 420-23.[WoS]
  • 6. Dutau H, Breen DP, Gomez C et al.: The integrated place of tracheo-bronchial stents in the multidisciplinary management of large post-pneumonectomy fistulas: our experience using a novel customised conical self-expandable metallic stent. Eur J Cardiothorac Surg 2011; 39: 1858-59.[WoS]
  • 7. Shin JH, Song HY, Ko GY: Esophagorespiratory Fistula: Long-term Results of Palliative Treatment with Covered Expandable Metallic Stents in 61 Patients. Radiology 2004; 232: 252-59.
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_pjs-2014-0095
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