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Endoscopic occlusion with silicone spigots for the closure of refractory esophago-bronchiole fistula after esophagectomy.

Authors
  • Uesato, Masaya1
  • Kono, Tsuguaki1
  • Akutsu, Yasunori1
  • Murakami, Kentarou1
  • Kagaya, Akiko1
  • Muto, Yorihiko1
  • Nakano, Akira1
  • Aikawa, Mizuho1
  • Tamachi, Tomohide1
  • Amagai, Hiroyuki1
  • Arasawa, Takahiro1
  • Muto, Yasuhide1
  • Matsubara, Hisahiro1
  • 1 Masaya Uesato, Tsuguaki Kono, Yasunori Akutsu, Kentarou Murakami, Akiko Kagaya, Yorihiko Muto, Akira Nakano, Mizuho Aikawa, Tomohide Tamachi, Hiroyuki Amagai, Takahiro Arasawa, Yasuhide Muto, Hisahiro Matsubara, Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan. , (Japan)
Type
Published Article
Journal
World journal of gastroenterology
Publication Date
Jul 28, 2017
Volume
23
Issue
28
Pages
5253–5256
Identifiers
DOI: 10.3748/wjg.v23.i28.5253
PMID: 28811720
Source
Medline
Keywords
License
Unknown

Abstract

A 65-year-old man with cT1bN0M0 stage I middle thoracic esophageal cancer underwent subtotal esophagectomy and gastric tube reconstruction through the posterior mediastinal route after preoperative carbon-ion radiotherapy and chemotherapy in a clinical trial. Anastomotic leakage occurred, but it spontaneously improved. At six months after the operation, he was rehospitalized with a cough and dysphagia. An esophago-bronchiole fistula and stenosis of the gastric tube were observed. He first underwent stent placement in the gastric tube. Two weeks later, the syringeal epithelium was burned by argon plasma coagulation after stent removal. Endoscopic occlusion was then performed for the fistula with two guidewire-assisted silicone spigots. Two weeks later, he was discharged on an oral diet, and he has not developed recurrence of the fistula or cancer for three years. This is the first report of endoscopic occlusion with a guidewire-assisted silicone spigot through the esophagus.

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