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Multidisciplinary team approach on tracheoesophageal fistula in a patient with home ventilator

A 68-year-old man was transferred to our tertiary hospital. Ten years ago, he received radiation therapy for tonsil cancer, and while there was no evidence of recurrence, he suffered from recurrent aspiration. We treated his aspiration pneumonia in the intensive care unit. Prior to his discharge, he...

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Autores principales: Kang, Hyeran, Yi, Kyung Sik, Kim, Sun-Hyung, Yang, Bumhee, Cho, Jun Yeun, Choe, Kang Hyeon, Lee, Ki Man, Shin, Yoon Mi, Suen, Hon Chi, Vannucci, Jacopo, Fiorelli, Alfonso
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9641333/
https://www.ncbi.nlm.nih.gov/pubmed/36389333
http://dx.doi.org/10.21037/jtd-22-675
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author Kang, Hyeran
Yi, Kyung Sik
Kim, Sun-Hyung
Yang, Bumhee
Cho, Jun Yeun
Choe, Kang Hyeon
Lee, Ki Man
Shin, Yoon Mi
Suen, Hon Chi
Vannucci, Jacopo
Fiorelli, Alfonso
author_facet Kang, Hyeran
Yi, Kyung Sik
Kim, Sun-Hyung
Yang, Bumhee
Cho, Jun Yeun
Choe, Kang Hyeon
Lee, Ki Man
Shin, Yoon Mi
Suen, Hon Chi
Vannucci, Jacopo
Fiorelli, Alfonso
author_sort Kang, Hyeran
collection PubMed
description A 68-year-old man was transferred to our tertiary hospital. Ten years ago, he received radiation therapy for tonsil cancer, and while there was no evidence of recurrence, he suffered from recurrent aspiration. We treated his aspiration pneumonia in the intensive care unit. Prior to his discharge, he received percutaneous dilatational tracheostomy (PDT) before he was transferred to a nursing hospital. Nine months later, he was readmitted owing to tracheoesophageal fistula (TEF). However, he was considered unsuitable for conservative intervention after a multidisciplinary team discussion. Esophageal stent insertion was impossible due to the high level of TEF in the esophagus. Additionally, the size of the TEF could not be covered by an endosponge and endoluminal vacuum therapy, and there was no tracheal stent that could cover his large trachea. The preceding percutaneous enteral gastrostomy (PEG) procedure was required for the primary closure operation of the esophagus; however, family’s consent could not be obtained. After 1month, the patient and his family changed their minds and agreed to the procedure and we attempted to perform PEG procedure. However, we could not proceed with PEG owing to stenosis in the inlet of the esophagus. Then, the patient deteriorated clinically and died due to pneumonia with septic shock.
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spelling pubmed-96413332022-11-15 Multidisciplinary team approach on tracheoesophageal fistula in a patient with home ventilator Kang, Hyeran Yi, Kyung Sik Kim, Sun-Hyung Yang, Bumhee Cho, Jun Yeun Choe, Kang Hyeon Lee, Ki Man Shin, Yoon Mi Suen, Hon Chi Vannucci, Jacopo Fiorelli, Alfonso J Thorac Dis iMDT Corner A 68-year-old man was transferred to our tertiary hospital. Ten years ago, he received radiation therapy for tonsil cancer, and while there was no evidence of recurrence, he suffered from recurrent aspiration. We treated his aspiration pneumonia in the intensive care unit. Prior to his discharge, he received percutaneous dilatational tracheostomy (PDT) before he was transferred to a nursing hospital. Nine months later, he was readmitted owing to tracheoesophageal fistula (TEF). However, he was considered unsuitable for conservative intervention after a multidisciplinary team discussion. Esophageal stent insertion was impossible due to the high level of TEF in the esophagus. Additionally, the size of the TEF could not be covered by an endosponge and endoluminal vacuum therapy, and there was no tracheal stent that could cover his large trachea. The preceding percutaneous enteral gastrostomy (PEG) procedure was required for the primary closure operation of the esophagus; however, family’s consent could not be obtained. After 1month, the patient and his family changed their minds and agreed to the procedure and we attempted to perform PEG procedure. However, we could not proceed with PEG owing to stenosis in the inlet of the esophagus. Then, the patient deteriorated clinically and died due to pneumonia with septic shock. AME Publishing Company 2022-10 /pmc/articles/PMC9641333/ /pubmed/36389333 http://dx.doi.org/10.21037/jtd-22-675 Text en 2022 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle iMDT Corner
Kang, Hyeran
Yi, Kyung Sik
Kim, Sun-Hyung
Yang, Bumhee
Cho, Jun Yeun
Choe, Kang Hyeon
Lee, Ki Man
Shin, Yoon Mi
Suen, Hon Chi
Vannucci, Jacopo
Fiorelli, Alfonso
Multidisciplinary team approach on tracheoesophageal fistula in a patient with home ventilator
title Multidisciplinary team approach on tracheoesophageal fistula in a patient with home ventilator
title_full Multidisciplinary team approach on tracheoesophageal fistula in a patient with home ventilator
title_fullStr Multidisciplinary team approach on tracheoesophageal fistula in a patient with home ventilator
title_full_unstemmed Multidisciplinary team approach on tracheoesophageal fistula in a patient with home ventilator
title_short Multidisciplinary team approach on tracheoesophageal fistula in a patient with home ventilator
title_sort multidisciplinary team approach on tracheoesophageal fistula in a patient with home ventilator
topic iMDT Corner
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9641333/
https://www.ncbi.nlm.nih.gov/pubmed/36389333
http://dx.doi.org/10.21037/jtd-22-675
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