Benign tracheo-neo-esophageal fistulas after subtotal esophagectomy.
BACKGROUND
Benign tracheo-neo-esophageal fistulas after esophagectomy are rare and treatment can be challenging. They can result from perioperative tracheal injury or various postoperative complications.


METHODS
Charts of 6 patients with a benign tracheoneo-esophageal fistula after subtotal esophagectomy treated in this institution between July 1993 and August 1999 were analyzed.


RESULTS
Three men and 3 women (median age 61 years) developed a fistula after subtotal esophagectomy. Symptoms varied from mild swallowing difficulties to aspiration pneumonia and mediastinitis. Two patients with mild symptoms were treated conservatively. In 1 patient a long fistula was partly excised through the neck. In 3 patients the gastric tube was excluded or excised, with surgical closure of the tracheal defect. The alimentary tract was reconstructed by colonic interposition. There were no major complications. After a median follow-up of 1.6 years, all fistulas were closed. All patients were capable of sufficient oral intake.


CONCLUSIONS
A benign tracheo-neo-esophageal fistula after esophagectomy is a rare, but serious complication. Site and size of the fistula, together with the severity of symptoms, should dictate management.
Buskens
C J
CJ
Department of Surgery, Academic Medical Center/University of Amsterdam, The Netherlands. c.j.buskens@amc.uva.nl
Hulscher
J B
JB
Fockens
P
P
Obertop
H
H
van Lanschot
J J
JJ
D000368:Aged; D003106:Colon / Q000637:transplantation; D016629:Esophagectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011859:Radiography; D012086:Reoperation; D013270:Stomach / Q000601:surgery; D013529:Surgical Wound Dehiscence / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D014138:Tracheoesophageal Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*