Managing esophageal fistulae by endoscopic transluminal drainage in esophageal cancer patients with superior mediastinal sepsis after esophagectomy

• Published in: Ai zheng Vol. 32; no. 8; pp. 469 - 473
• Main Authors: Zheng, Yu-Zhen, Dai, Shu-Qin, Shan, Hong-Bo, Gao, Xiao-Yan, Zhang, Lan-Jun, Cao, Xun, Zhu, Jian-Fei, Wang, Jun-Ye
• Format: Journal Article
• Language: English
• Published: England State Key Laboratory of 0ncology in South China, Guangzhou, Guangdong 510060, P. R. China 01.08.2013; Sun Yat-sen University Cancer Center
• Subjects: Aged; Carcinoma, Squamous Cell - surgery; Case Research; Drainage; Endoscopy; Esophageal Fistula - etiology; Esophageal Fistula - therapy; Esophageal Neoplasms - surgery; Esophageal Squamous Cell Carcinoma; Esophagectomy - adverse effects; Humans; Lymph Node Excision; Male; Mediastinum; Middle Aged; Sepsis - etiology; Sepsis - therapy; 临床管理; 内镜; 引流; 患者; 腔内; 败血症; 食管癌; 鳞状细胞癌; anastomotic fistulae; transluminal drainage; Esophageal squamous cel carcinoma
• ISSN: 1000-467X; 1944-446X
• DOI: 10.5732/cjc.012.10154

The management of postoperative leaks into the mediastinum after esophagectomy remains a challenge. We describe our clinical management of this complication through endoscopic transluminal drainage. Between 2008 and 2011, 4 patients with esophageal squamous cell carcinoma （ESCC） who underwent McKeown-type esophagectomy with two-field lymphadenectomy experienced complicated anastomotic fistulae in the presence of superior mediastinal sepsis. All 4 patients underwent endoscopic transluminal drainage, and all survived. The mean healing period was 50 days （range, 31 to 58 days）, the mean stay in the intensive care unit was 7.3 days （range, 1 to 18 days）, and the mean hospital stay was 64.5 days （range, 49 to 70 days）. Endoscopically guided transluminal drainage should be considered for ESCC patients with superior mediastinal fistulae after esophagectomy.