title: Managing esophageal fistulae by endoscopic transluminal drainage in esophageal cancer patients with superior mediastinal sepsis after esophagectomy.
abstract: The management of postoperative leaks into the mediastinum after esophagectomy remains a challenge. We describe our clinical management of this complication through endoscopic transluminal drainage. Between 2008 and 2011, 4 patients with esophageal squamous cell carcinoma (ESCC) who underwent McKeown-type esophagectomy with two-field lymphadenectomy experienced complicated anastomotic fistulae in the presence of superior mediastinal sepsis. All 4 patients underwent endoscopic transluminal drainage, and all survived. The mean healing period was 50 days (range, 31 to 58 days), the mean stay in the intensive care unit was 7.3 days (range, 1 to 18 days), and the mean hospital stay was 64.5 days (range, 49 to 70 days). Endoscopically guided transluminal drainage should be considered for ESCC patients with superior mediastinal fistulae after esophagectomy.
authors.affiliation: State Key Laboratory of Oncology in South China; Department of Thoracic Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China. wangjy@sysucc.org.cn.
authors.forename: Yu-Zhen
authors.initials: YZ
authors.lastname: Zheng
authors.forename: Shu-Qin
authors.initials: SQ
authors.lastname: Dai
authors.forename: Hong-Bo
authors.initials: HB
authors.lastname: Shan
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Gao
authors.forename: Lan-Jun
authors.initials: LJ
authors.lastname: Zhang
authors.forename: Xun
authors.initials: X
authors.lastname: Cao
authors.forename: Jian-Fei
authors.initials: JF
authors.lastname: Zhu
authors.forename: Jun-Ye
authors.initials: JY
authors.lastname: Wang
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004322:Drainage; D004724:Endoscopy; D004937:Esophageal Fistula / Q000209:etiology / Q000628:therapy*; D004938:Esophageal Neoplasms / Q000601:surgery*; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy / Q000009:adverse effects*; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D018805:Sepsis / Q000209:etiology / Q000628:therapy