JOURNAL OF JAPAN SOCIETY FOR ENDOSCOPIC SURGERY Volume 24, Issue 2 (March 2019)
Japanese

Minimally invasive surgery for gastro-tracheal fistula after esophagectomy Shohei MATSUFUJI 1 , Hironori IWASAKI 1 , Yukie YODA 1 , Hirokazu NOSHIRO 1 1Department of Surgery, Saga University Keyword: 胸腔鏡下食道亜全摘出術 , 胃管気管瘻 , 胸腔鏡下手術 pp.116-121
Published Date 2019/3/15
DOI https://doi.org/10.11477/mf.4426200679
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 Gastro-tracheal fistula after esophagectomy for esophageal cancer is a comparatively rare complication. Various factors, such as prolonged intubation, anastomotic leakage, necrosis of gastric conduit, microabscess of staple line on the conduit, contribute to gastro-tracheal fistula development. Some reports have suggested that conservative therapy is effective, but in most cases, surgical intervention is necessary. In our institution, we have had two cases in which we were able to treat gastro-tracheal fistula successfully with thoracoscopic surgery. Both patients had undergone minimally invasive esophagectomy for esophageal cancer. In both cases, gastro-tracheal fistula developed between anastomotic site of gastric conduit and trachealis muscle. Various examinations showed that the cause of the fistula was located on the anastomotic site of gastric conduit and the fistula was small, measuring 5 mm in diameter. Because esophagectomy had been performed with thoracoscopy and gastro-tracheal fistula was comparatively small, we decided that it could be repaired with thoracoscopic surgery. Intraoperative findings revealed a small hole on trachealis muscle and its surrounding tissue was not so damaged. Therefore, we decided that the hole on the trachea could be closed with simple interrupted sutures. In one case pericardium was used for reinforcement of the closure, and omentum of gastric conduit for the other. Their postoperative courses were uneventful. In this report, we presented two cases in detail and discussed about the criteria of minimally invasive surgery for gastro-tracheal fistula after esophagectomy.


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基本情報

13446703.24.2.jpg
日本内視鏡外科学会雑誌
24巻2号 (2019年3月)
電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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