Long-term results of surgical treatment in benign bronchoesophageal fistula

• Published in: The Journal of thoracic and cardiovascular surgery Vol. 134; no. 2; pp. 411 - 414
• Main Authors: Kim, Hong Kwan, MD, Choi, Yong Soo, MD, Kim, Kwhanmien, MD, Kim, Jhingook, MD, Shim, Young Mog, MD
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Mosby, Inc 01.08.2007; AATS/WTSA; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Bronchial Fistula - surgery; Bronchoscopy; Cardiothoracic Surgery; Esophageal Fistula - surgery; Esophagoscopy; Female; Humans; Male; Medical sciences; Middle Aged; Postoperative Complications; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Survival Rate; Treatment Outcome; 8; BEF; 15; bronchoesophageal fistula; Heart; Prognosis; Treatment; Surgical fistula; Surgery; Thorax; Long term
• ISSN: 0022-5223; 1097-685X
• DOI: 10.1016/j.jtcvs.2007.04.030

Objectives Benign bronchoesophageal fistula is a rare complication resulting from various diseases. The objectives of the study are to report our surgical experience in patients with benign bronchoesophageal fistulas and to evaluate the long-term results of surgical management. Methods Between 1995 and 2005, a total of 14 patients (mean age, 52.5 years; male/female = 6:8) underwent operations for benign bronchoesophageal fistulas. The etiology of the fistulas included traction esophageal diverticula in 7 patients and tuberculous lymphadenopathy in 6. Primary repair of the fistula was performed in all patients and a concomitant lobectomy in 6. Results There was no in-hospital mortality. Postoperative complications occurred in 1 patient (empyema resulting from a leakage at the repair site). Postoperative esophagography revealed a leakage at the repair site in 1 patient. There was 1 late death with a mean follow-up of 43.9 months. The cause of death was aspiration pneumonia resulting from recurrent fistula. Two of 8 patients who did not undergo a lobectomy had persistent bronchiectasis, whereas none of those who underwent a concomitant lobectomy had any recurrent pneumonia or bronchiectasis. The overall survival was 100% at 5 years and the mean survival time was 124 months (95% confidence interval, 106.5-142.2 months). Conclusions We conclude from these data that early detection and definitive surgical repair of benign bronchoesophageal fistulas can yield high success rates with excellent early outcomes and good long-term results.