Benign bronchoesophageal fistula in adults: endoscopic closure as primary treatment.
OBJECTIVE
Benign bronchoesophageal fistula (BEF) is a rare condition that is usually treated surgically; however, less invasive endoscopy procedures have been attempted to overcome the disadvantages of surgery. The aim of this study was thus to determine the results of endoscopic management as a primary treatment in patients with BEF.


METHODS
We retrospectively analyzed data from 368 patients with BEF who were treated at a tertiary care, academic medical center between January 2000 and August 2009.


RESULTS
Benign causes were found for only 18 of the 368 patients. Of these, seven were treated endoscopically and the others by surgery or other methods. The first endoscopy procedures failed in all seven patients, with second trials of endoscopy performed in four patients at a median of 8 days (range, 3 to 11 days) after the first procedure. The second endoscopic procedure was successful in two out of four patients; one patient showed no recurrence of the fistula, whereas the second patient experienced a recurrence after 24 months. All patients underwent successful surgical procedures after the failure of endoscopic treatment, with no further recurrences.


CONCLUSIONS
Although we observed a low rate of success for primary endoscopic treatment of benign BEF, the invasive nature of surgery suggests the need for a prospective study with a large number of patients to evaluate the efficacy of less invasive procedures such as endoscopic treatment.
Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ji Yong
JY
Ahn
Hwoon-Yong
HY
Jung
Ji Young
JY
Choi
Mi-Young
MY
Kim
Jeong Hoon
JH
Lee
Kwi-Sook
KS
Choi
Do Hoon
DH
Kim
Kee Don
KD
Choi
Ho June
HJ
Song
Gin Hyug
GH
Lee
Jin-Ho
JH
Kim
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