Contralateral approach for congenital bronchoesophageal fistula in an adult

Abstract

The patient was a 74-year-old female who had frequently suffered from pneumonia, hemoptysis, and cough after food ingestion for forty years. She had been diagnosed with congenital bronchoesophageal fistula and referred to our hospital for surgery. The fistula was between the lower portion of the esophagus and right lower lobe of the lung. The right lower lobe was destroyed because of repeated pneumonia. She refused blood transfusion on religious grounds. To avoid massive bleeding and the need for blood transfusion, the operation was performed through a left-sided mini-thoracotomy, and the fistula was freed easily from neighboring tissue, such as the esophagus, lung, and left lower pulmonary vein, and divided by GIA without freeing the adhesion of the right thorax. The post-operative course has been satisfactory, with no recurrence of cough, hemoptysis, or pneumonia since the operation.