Universität zu Köln

Lambertz, R., Hoelscher, A. H., Bludau, M., Leers, J. M., Gutschow, C. and Schroeder, W. (2016). Management of Tracheo- or Bronchoesophageal Fistula After Ivor-Lewis Esophagectomy. World J.Surg., 40 (7). S. 1680 - 1688. NEW YORK: SPRINGER. ISSN 1432-2323

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Abstract

The development of tracheo- or bronchoesophageal fistula (TBF) after Ivor-Lewis esophagectomy remains to be a rare complication associated with a high mortality rate. In this retrospective study, the charts of patients with TBF after esophagectomy were analyzed in terms of individual patient characteristics, esophagotracheal complications, respiratory function, management, and outcome. Between January 2000 and December 2014, 1204 patients underwent Ivor-Lewis esophagectomy for esophageal cancer; 13 patients (1.1 %) developed a TBF. In all 13 patients, a concomitant leakage of the intrathoracic esophagogastrostomy was evident, either prior to diagnosis of TBF (metachronous TBF) or simultaneously (synchronous TBF). TBF was predominantly located in the left main bronchus (n = 6, 46.1 %) or trachea (n = 5, 38.5 %). Management of TBF included re-thoracotomy (n = 7), interventional endoscopic (n = 10) or bronchoscopic therapy (n = 4). In the majority of patients (n = 8), management consisted of two subsequent treatment modalities. In 3 out of four patients, TBF was successfully treated by endoscopic stenting only. Five patients (38.5 %) died following a septic course with multiple organ failure. The development of TBF after Ivor-Lewis esophagectomy is always combined with anastomotic leakage of the esophagogastrostomy. Treatment options primarily depend on the vascularization of the gastric conduit, the severity of the concomitant aspiration pneumonia, and the volume of the air leakage.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lambertz, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, A. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bludau, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Leers, J. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gutschow, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-271266
DOI:	10.1007/s00268-016-3470-9
Journal or Publication Title:	World J.Surg.
Volume:	40
Number:	7
Page Range:	S. 1680 - 1688
Date:	2016
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-2323
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TRACHEOBRONCHIAL FISTULA; GASTROESOPHAGEAL CANCER; PROSPECTIVE COHORT; COMPLICATIONS; MORBIDITY; MORTALITY; SURGERY; STENT Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27126