Successful Endoscopic Treatment of a Postoperative Tracheomediastinal Fistula Caused by Anastomotic Insufficiency after Esophageal Resection with Fibrin Glue

• Authors: Guenter Weiss , Cora Wex , Hans Lippert , Jens Schreiber , Frank Meyer
• Languages of publication: EN

Abstracts

EN

Fistula development after esophageal resection is considered as one of the most serious postoperative complications.The authors reported a case on clinical experiences in the postoperative diagnostic and successful therapeutic management of a tracheomediastinal fistula after esophageal resection, using endoscopic application of fibrin glue.The early approach of an anastomotic insufficiency after esophageal resection because of a squamous cell carcinoma (pT3pN0M0G2) below the tracheal bifurcation including transposition of a re-modelled gastric tube and end-to-side anastomosis 24 hours postoperatively in a 55-year old patient combined i) surgical re-intervention from the periesophageal site (reanastomosis, gastroplication, lavage, local and mediastinal drainage) and, later on, ii) extensive rinsing with consecutive endoscopic fibrin glue application into the tracheal mouth of the subsequently developed tracheomediastinal fistula as a consequence of the inflammatory changes within the surrounding tissue.In conclusion, this approach was successful and beneficial for the patient's further postoperative course, which was associated with other complications such as pneumonia and acute myocardial infarction. The fistula closed sufficiently and permanently with no further surgical intervention at the tracheal as well as mediastinal site and allowed patient's later discharge with no further complaints or problems.

Keywords

EN

tracheomediastinal fistula; esophageal resection; fibrin glue; endoscopic approach

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2015
• Volume: 86
• Issue: 11
• Pages: 537-539

Dates

received

15 - 12 - 2013

online

3 - 2 - 2015

Contributors

author

Guenter Weiss

• Department of Anesthesiology and Intensive Care, Municipal Hospital, Magdeburg, Germany

author

Cora Wex

• Department of General, Abdominal and Vascular Surgery, University Hospital in Magdeburg, Germany

author

Hans Lippert

• Department of General, Abdominal and Vascular Surgery, University Hospital in Magdeburg, Germany

author

Jens Schreiber

• Division of Pulmonology, Department of Cardiology, Pulmonology and Angiology, University Hospital in Magdeburg, Germany

author

Frank Meyer

• Department of General, Abdominal and Vascular Surgery, University Hospital in Magdeburg, Germany

References

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Identifiers

DOI

10.2478/pjs-2014-0095