Use of esophageal stent for the treatment of postoperative gastrointestinal–airway fistula after esophagectomy

• Published in: Esophagus : official journal of the Japan Esophageal Society Vol. 16; no. 4; pp. 413 - 417
• Main Authors: Okamoto, Koichi, Ninomiya, Itasu, Fujiwara, Yuta, Mochizuki, Ichitaro, Aoki, Tatsuya, Yamaguchi, Takahisa, Terai, Shiro, Nakanuma, Shinichi, Kinoshita, Jun, Makino, Isamu, Nakamura, Keishi, Miyashita, Tomoharu, Tajima, Hidehiro, Takamura, Hiroyuki, Fushida, Sachio, Ohta, Tetsuo
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.10.2019; Springer Nature B.V
• Subjects: Endoscopy; Esophageal cancer; Esophagus; Fistula; Gastroenterology; Gastrointestinal surgery; How I Do It; Medicine; Medicine & Public Health; Postoperative period; Stents; Surgical Oncology; Thoracic Surgery; Throat surgery; Esophageal stent; Esophageal fistula; Esophageal cancer
• ISSN: 1612-9059; 1612-9067
• DOI: 10.1007/s10388-019-00673-0

A gastrointestinal–airway fistula (GAF) after esophagectomy is a very serious postoperative complication that can cause severe respiratory complications due to digestive juice inflow. Generally, GAF is managed by invasive surgical treatment; less-invasive treatment has yet to be established. We performed esophageal stent placement (ESP) in three cases of GAF after esophagectomy. We assessed the usefulness of ESP through our clinical experience. All GAFs were successfully managed by ESP procedures. After the procedure, the stent positioning and expansion were appropriately evaluated by radiological assessments over time. The stent was removed after endoscopic confirmation of fistula closure on days 8, 23, and 71. Only one patient with a long-term indwelling stent developed a manageable secondary gastrobronchial fistula as a procedure-related complication. In conclusion, ESP was shown to be a less-invasive and effective therapeutic modality for the treatment of GAF.