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Treatment strategy for benign gastric tube-tracheobronchial fistula after esophagectomy for esophageal cancer: 9 case reports and review of the literature

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Abstract

Background

Benign gastric tube-tracheobronchial fistula after esophagectomy for esophageal cancer is a rare life-threatening complication observed after gastric tube reconstruction via the posterior mediastinal route. However, the literature for this complication is limited, comprising only a few case reports; therefore, its treatment strategy remains unclear. Here, we have summarized such cases that were managed at our institution and have reviewed previous literature in order to design a relevant treatment strategy for this complication.

Methods

We have included nine cases of benign gastric tube-tracheobronchial fistula after esophagectomy for esophageal cancer that were encountered during 1993–2011, with their clinical features, treatment methods, and outcomes. In addition, 37 reports published during 1990–2012 from the PubMed database comprising 61 such cases have been reviewed. A total of 70 patients (published cases and our cases) were analyzed with regard to pathogenesis, treatment methods, and outcomes.

Results

The fistula type was found to determine the fistula site. Surgical treatment had the highest recovery rate of any of the types of benign gastric tube-tracheobronchial fistula after esophagectomy for esophageal cancer; further, approximately 30 % of the patients who initially received conservative or endoscopic treatment required conversion to operative treatment. Cases wherein leakage occurred were more frequently managed by conservative and endoscopic treatments than other types of such fistulas, with a good recovery rate.

Conclusions

We conclude that the primary treatment for benign gastric tube-tracheobronchial fistula after esophagectomy for esophageal cancer is surgery based on the fistula type and site.

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Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Digestive Surgery, Niigata City General Hospital, 463-7 Shumoku, Chuo-ku, Niigata, 950-1197, Japan

    Shirou Kuwabara, Akiko Tonouchi, Shoichi Manabe, Natsuru Sudo, Tomohiro Katada, Shinichiro Ishino, Akira Iwaya, Naoyuki Yokoyama, Toshiyuki Yamazaki, Tetsuya Otani & Norio Ktayanagi

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  1. Shirou Kuwabara
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  2. Akiko Tonouchi
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  3. Shoichi Manabe
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  4. Natsuru Sudo
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  5. Tomohiro Katada
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  6. Shinichiro Ishino
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  7. Akira Iwaya
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  8. Naoyuki Yokoyama
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  9. Toshiyuki Yamazaki
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  10. Tetsuya Otani
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  11. Norio Ktayanagi
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Corresponding author

Correspondence to Shirou Kuwabara.

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Kuwabara, S., Tonouchi, A., Manabe, S. et al. Treatment strategy for benign gastric tube-tracheobronchial fistula after esophagectomy for esophageal cancer: 9 case reports and review of the literature. Esophagus 10, 135–143 (2013). https://doi.org/10.1007/s10388-013-0372-x

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  • DOI: https://doi.org/10.1007/s10388-013-0372-x

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