An endoscopic repair option for acquired esophagorespiratory fistulas.
Benign acquired esophagorespiratory fistulas (BERFs) represent a broad spectrum of anatomic pathology presenting in a wide variety of clinical settings. These fistulas can lead to severe respiratory compromise and rarely close spontaneously. Surgical fistula closure has been the traditional therapeutic approach, but is associated with significant morbidity and mortality. The recent advent of endoscopic technologies suggests that minimally invasive procedures may offer a safe alternative to surgery for the treatment of esophagorespiratory fistulas. In this article, we present our experience in treating complex benign esophagorespiratory fistulas of diverse etiologies utilizing a primarily minimal invasive, endoscopic, or combined surgical and endoscopic approaches. Our experience demonstrates that an endoscopic-based approach is safe and technically feasible and can, potentially, spare a subset of patients from open surgery. A multidisciplinary decision-making process, based on individualized parameters, is a prerequisite for a successful outcome.
Schlager
Avraham
A
Department of General Surgery, New York University Hospital, New York, New York 10016, USA. avi.schlager@gmail.com
Khalaileh
Abed
A
Zamir
Gideon
G
Mintz
Yoav
Y
Jacob
Harold
H
Rivkind
Avraham I
AI
D000328:Adult; D001983:Bronchial Fistula / Q000209:etiology / Q000601:surgery*; D017577:Cutaneous Fistula / Q000209:etiology / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D004936:Diverticulum, Esophageal / Q000601:surgery*; D004724:Endoscopy; D004937:Esophageal Fistula / Q000209:etiology / Q000601:surgery*; D005240:Feasibility Studies; D006801:Humans; D017075:Laser Coagulation; D054020:Lasers, Gas; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000209:etiology / Q000601:surgery*; D012086:Reoperation