title: Successful Anesthesia Management for 2-Stage Surgical Procedure of a Refractory Tracheogastric Tube Fistula After Esophagectomy.
abstract: Tracheogastric tube fistulas are rare but fatal complications after esophagectomy. Anesthetic management for a patient with this complication is challenging because air leakage and mechanical ventilation may cause aspiration. We present a case report of the anesthetic management of a patient having 2-stage surgical repair combined with endoscopic mucosal resection for a giant carinal tracheogastric tube fistula. The first stage was separation of the gastric tube above the fistula with spontaneous breathing under local anesthesia and sedation. The second stage was complete separation and reconstruction of the digestive tract under epidural and general anesthesia with spontaneous breathing and pressure support before insertion of a decompression tube.
authors: From the Departments of *Anesthesiology and †Esophageal and General Surgery, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Tokyo, Japan.
authors: Tomoko
authors: T
authors: Ishibashi
authors: Seiji
authors: S
authors: Ishikawa
authors: Akiko
authors: A
authors: Suzuki
authors: Yutaka
authors: Y
authors: Miyawaki
authors: Tatsuyuki
authors: T
authors: Kawano
authors: Koshi
authors: K
authors: Makita
mesh_terms: D000368:Aged; D000758:Anesthesia / Q000379:methods*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D005747:Gastric Fistula / Q000150:complications*; D006801:Humans; D011183:Postoperative Complications / Q000601:surgery; D016156:Respiratory Tract Fistula / Q000601:surgery*; D014133:Tracheal Diseases / Q000601:surgery*