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Esophageal bypass surgery as a definitive repair of recurrent acquired benign bronchoesophageal fistula

BACKGROUND: Acquired benign bronchoesophageal fistula (BEF) is rare and develops as a complication of other diseases, mostly of inflammatory processes and traumas of the chest. The treatment of choice is a surgical repair, which is considered definitive and leads to successful outcomes. However, inc...

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Autores principales: Vachtenheim, Jiri, Lischke, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458707/
https://www.ncbi.nlm.nih.gov/pubmed/30971283
http://dx.doi.org/10.1186/s13019-019-0902-2
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author Vachtenheim, Jiri
Lischke, Robert
author_facet Vachtenheim, Jiri
Lischke, Robert
author_sort Vachtenheim, Jiri
collection PubMed
description BACKGROUND: Acquired benign bronchoesophageal fistula (BEF) is rare and develops as a complication of other diseases, mostly of inflammatory processes and traumas of the chest. The treatment of choice is a surgical repair, which is considered definitive and leads to successful outcomes. However, incidence of recurrence after the primary repair based on limited data is up to 10% and its treatment is challenging. We report a surgical case of a patient with recurrent acquired benign BEF after primary resection and ensuing successful definitive repair with esophageal bypass surgery after temporary esophageal stenting. CASE REPORT: A 46-year-old male was referred to our department with a symptomatic left-sided bronchoesophageal fistula as a complication of severe acute necrotizing mediastinitis that originated from odontogenic abscess. Previously, several cervicotomies and bilateral thoracotomy were performed at an external medical facility to manage the acute condition. We performed resection of the fistula through re-thoracotomy. Postprocedural esophagography demonstrated a recurrence of bronchoesophageal communication. Postinflammatory adhesions excluded further repair through thoracotomy, therefore a stent was introduced in the esophagus for 12 weeks. Thereafter, an esophageal bypass surgery using a substernaly interposed gastric conduit was performed and resulted in an excellent long-term outcome. CONCLUSIONS: Esophageal bypass surgery using a substernaly interposed gastric conduit may be considered if the standard surgical repair of acquired benign bronchoesophageal fistula is not successful or feasible.
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spelling pubmed-64587072019-04-19 Esophageal bypass surgery as a definitive repair of recurrent acquired benign bronchoesophageal fistula Vachtenheim, Jiri Lischke, Robert J Cardiothorac Surg Case Report BACKGROUND: Acquired benign bronchoesophageal fistula (BEF) is rare and develops as a complication of other diseases, mostly of inflammatory processes and traumas of the chest. The treatment of choice is a surgical repair, which is considered definitive and leads to successful outcomes. However, incidence of recurrence after the primary repair based on limited data is up to 10% and its treatment is challenging. We report a surgical case of a patient with recurrent acquired benign BEF after primary resection and ensuing successful definitive repair with esophageal bypass surgery after temporary esophageal stenting. CASE REPORT: A 46-year-old male was referred to our department with a symptomatic left-sided bronchoesophageal fistula as a complication of severe acute necrotizing mediastinitis that originated from odontogenic abscess. Previously, several cervicotomies and bilateral thoracotomy were performed at an external medical facility to manage the acute condition. We performed resection of the fistula through re-thoracotomy. Postprocedural esophagography demonstrated a recurrence of bronchoesophageal communication. Postinflammatory adhesions excluded further repair through thoracotomy, therefore a stent was introduced in the esophagus for 12 weeks. Thereafter, an esophageal bypass surgery using a substernaly interposed gastric conduit was performed and resulted in an excellent long-term outcome. CONCLUSIONS: Esophageal bypass surgery using a substernaly interposed gastric conduit may be considered if the standard surgical repair of acquired benign bronchoesophageal fistula is not successful or feasible. BioMed Central 2019-04-11 /pmc/articles/PMC6458707/ /pubmed/30971283 http://dx.doi.org/10.1186/s13019-019-0902-2 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Vachtenheim, Jiri
Lischke, Robert
Esophageal bypass surgery as a definitive repair of recurrent acquired benign bronchoesophageal fistula
title Esophageal bypass surgery as a definitive repair of recurrent acquired benign bronchoesophageal fistula
title_full Esophageal bypass surgery as a definitive repair of recurrent acquired benign bronchoesophageal fistula
title_fullStr Esophageal bypass surgery as a definitive repair of recurrent acquired benign bronchoesophageal fistula
title_full_unstemmed Esophageal bypass surgery as a definitive repair of recurrent acquired benign bronchoesophageal fistula
title_short Esophageal bypass surgery as a definitive repair of recurrent acquired benign bronchoesophageal fistula
title_sort esophageal bypass surgery as a definitive repair of recurrent acquired benign bronchoesophageal fistula
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458707/
https://www.ncbi.nlm.nih.gov/pubmed/30971283
http://dx.doi.org/10.1186/s13019-019-0902-2
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