Diagnosis and treatment of cervical anastomotic fistula contaminating mediastinum or pleural cavity after esophagogastrostomy: a report of five cases with literature review

• Published in: Ai zheng = Aizheng = Chinese journal of cancer Vol. 24; no. 10; p. 1280
• Main Authors: Chen, Gang, Xie, Liang, Tang, Ji-Ming, Ben, Xiao-Song, Yang, Xue-Ning
• Format: Journal Article
• Language: Chinese
• Published: China 01.10.2005
• Subjects: Adult; Anastomosis, Surgical - adverse effects; Anti-Bacterial Agents - therapeutic use; Bronchial Fistula - diagnosis; Bronchial Fistula - etiology; Bronchial Fistula - therapy; Carcinoma, Squamous Cell - surgery; Drainage; Esophageal Fistula - diagnosis; Esophageal Fistula - etiology; Esophageal Fistula - therapy; Esophageal Neoplasms - surgery; Esophagectomy - adverse effects; Female; Gastrostomy - adverse effects; Humans; Imipenem - therapeutic use; Male; Mediastinum - pathology; Middle Aged; Pleural Diseases - pathology; Retrospective Studies; Therapeutic Irrigation

A special kind of fistula will be formed when cervical gastroesophageal anastomotic fistula occurs and its contents contaminate mediastinum or pleural cavity after esophagogastrostomy. The diagnosis and treatment are difficult to made. It is very dangerous if the treatment is incorrect. This study was to analyze the causes, preventive measures, diagnosis methods and standard, and appropriate treatments of this kind of fistula. Clinical data of 5 patients who suffered cervical anastomotic fistula contaminating mediastinum or pleural cavity after esophagogastrostomy, treated in our hospital, were retrospectively analyzed; the related literature was reviewed. The morbidity of this kind fistula was 1.83%(4/219) in our hospital. All the 5 patients suffered fistula 1-13 days after esophagogastrostomy; bronchopleural fistula occurred in 2 patients. The main causes of this kind of anastomotic fistula were hypertensive anastomosis, low anastomotic location, incomplete suture of thorax-esophagus outlet, defection of su