Successful Treatment for Intractable Esophago-mediastinal Fistulas following Anastomotic Leakage after Esophageal Resection

Abstract

Treatment of esophagomediastinal fistulas after esophagectomy using a transthoracic drainage tube results in a cure in 83.3% of cases. If drainage is ineffective or US-guided drainage is difficult, CT-guided drainage is effective;however, the fistula in some cases cannot be closed. We were able to close such fistulas by inserting an esophageal self-expandable metallic stent and performing transesophageal drainage and irrigation followed by endoscopic sealing with fibrin glue. These procedures are minimally invasive and effective compared to surgical repair.