Skip to main content

Advertisement

SpringerLink
Log in

Endoscopic gluing for intrathoracic anastomotic fistula following esophagectomy: a case report

  • Case Report
  • Published:
Esophagus Aims and scope Submit manuscript

Abstract

Intrathoracic anastomotic leak/fistula following esophagectomy is a serious complication of this surgery. Patients are often extremely ill; endoscopic procedures have been suggested to avoid further surgical intervention. We herein present a case of a post-esophagectomy intrathoracic anastomotic fistula treated successfully with endoscopic gluing using N-butyl-2-cyanoacrylate. A 74-year-old Japanese woman was admitted to our hospital for treatment of a tumor of the esophagogastric junction. We performed distal esophagectomy, total gastrectomy via a left thoracotomy and laparotomy. Leakage at the esophagojejunostomy site was diagnosed on postoperative day 2. This leak gradually developed into a fistula through the drainage site. Because we judged the anastomotic fistula to be intractable by conservative treatment, we successfully closed the fistula by endoscopic gluing on postoperative day 44. This novel procedure shows that anastomotic fistula following esophagectomy can be sealed safely and effectively by endoscopic injection of N-butyl-2-cyanoacrylate glue.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kauer WK, Stein HJ, Dittler HJ, Siewert JR. Stent implantation as a treatment option in patients with thoracic anastomotic leaks after esophagectomy. Surg Endosc. 2008;22:50–3.

    Article  PubMed  Google Scholar 

  2. Schweigert M, Solymosi N, Dubecz A, Stadlhuber RJ, Muschweck H, Ofner D, et al. Endoscopic stent insertion for anastomotic leakage following oesophagectomy. Ann R Coll Surg Engl. 2013;95:43–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Rodella L, Laterza E, De Manzoni G, Kind R, Lombardo F, Catalano F, et al. Endoscopic clipping of anastomotic leakages in esophagogastric surgery. Endoscopy. 1998;30:453–6.

    Article  CAS  PubMed  Google Scholar 

  4. Mennigen R, Colombo-Benkmann M, Senninger N, Laukoetter M. Endoscopic closure of postoperative gastrointestinal leakages and fistulas with the over-the-scope clip (OTSC). J Gastrointest Surg. 2013;17:1058–65.

    Article  PubMed  Google Scholar 

  5. Schweigert M, Dubecz A, Stadlhuber RJ, Muschweck H, Stein HJ. Risk of stent-related aortic erosion after endoscopic stent insertion for intrathoracic anastomotic leaks after esophagectomy. Ann Thorac Surg. 2011;92:513–8.

    Article  PubMed  Google Scholar 

  6. Voermans RP, Le Moine O, von Renteln D, Ponchon T, Giovannini M, Bruno M, et al. Efficacy of endoscopic closure of acute perforations of the gastrointestinal tract. Clin Gastroenterol Hepatol. 2012;10:603–8.

    Article  PubMed  Google Scholar 

  7. Chang CC, Hsu HH, Kuo SW, Lee YC. Bronchoscopic gluing for post-lung-transplant bronchopleural fistula. Eur J Cardiothorac Surg. 2007;31:328–30.

    Article  PubMed  Google Scholar 

  8. Seewald S, Brand B, Groth S, Omar S, Mendoza G, Seitz U, et al. Endoscopic sealing of pancreatic fistula by using N-butyl-2-cyanoacrylate. Gastrointest Endosc. 2004;59:463–70.

    Article  PubMed  Google Scholar 

  9. Yagci B, Parildar M, Oran I, Memis A. Percutaneous interventional therapy of persistent biliary fistulas. Abdom Imaging. 2007;32:475–80.

    Article  PubMed  Google Scholar 

  10. Aslan G, Men S, Gülcü A, Kefi A, Esen A. Percutaneous embolization of persistent urinary fistula after partial nephrectomy using N-butyl-2-cyanoacrylate. Int J Urol. 2005;12:838–41.

    Article  PubMed  Google Scholar 

  11. Lee YC, Na HG, Suh JH, Park I-S, Chung KY, Kim NK. Three cases of fistulae arising from gastrointestinal tract treated with endoscopic injection of Histoacryl. Endoscopy. 2001;33:184–6.

    Article  CAS  PubMed  Google Scholar 

  12. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd english edition. Gastric Cancer. 2011;14:101–12.

    Article  Google Scholar 

  13. Raju GS. Tissue glue for the endoscopist: healing by sealing. Gastroenterology. 2004;127:1852–3.

    Article  PubMed  Google Scholar 

  14. Petersen B, Barkun A, Carpenter S, Chotiprasidhi P, Chuttani R, Silverman W, et al. Tissue adhesives and fibrin glues. Gastrointest Endosc. 2004;60:327–33.

    Article  PubMed  Google Scholar 

  15. Engler S, Dorlars D, Riemann JF. Endoscopic fibrin gluing of a pancreatic duct fistula following acute pancreatitis. Dtsch Med Wochenschr. 1996;121:1396–400.

    Article  CAS  PubMed  Google Scholar 

  16. Lippert E, Klebl FH, Schweller F, Ott C, Gelbmann CM, Schölmerich J, et al. Fibrin glue in the endoscopic treatment of fistulae and anastomotic leakages of the gastrointestinal tract. Int J Colorectal Dis. 2011;26:303–11.

    Article  PubMed  Google Scholar 

Download references

Ethical Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later revision. Informed consent or substitute for it was obtained from the present patient for being included in the study.

Conflict of interest

There are no financial or other relations that could lead to a conflict of interest.

Author information

Authors and Affiliations

  1. Department of Surgery, Gunma Chuo Hospital, 1-7-13 Kouun-cho, Maebashi, Gunma, 371-0025, Japan

    Minoru Fukuchi, Kana Saito & Hiroshi Naitoh

  2. Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, 371-8511, Japan

    Hiroyuki Kuwano

Authors
  1. Minoru Fukuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kana Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hiroshi Naitoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroyuki Kuwano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Minoru Fukuchi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fukuchi, M., Saito, K., Naitoh, H. et al. Endoscopic gluing for intrathoracic anastomotic fistula following esophagectomy: a case report. Esophagus 12, 332–335 (2015). https://doi.org/10.1007/s10388-014-0461-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10388-014-0461-5

Keywords

Search

Navigation