Two Cases of Intractable Enterocutaneous Fistulae Due to Anastomotic Leakage after Esophagogastrostomy That Were Successfully Treated with Negative Pressure Wound Therapy

Abstract

Intractable enterocutaneous fistula due to anastomotic leakage after esophagectomy for esophageal cancer continues to be a challenging complication. We present two cases of intractable enterocutaneous fistulae due to anastomotic leakage after esophagectomy that were successfully treated with negative pressure wound therapy (NPWT). The first case was a 68-year-old man who developed enterocutaneous fistula due to anastomotic leakage after esophagectomy with retrosternal gastric conduit reconstruction. The second case was a 69-year-old man who developed enterocutaneous fistula due to anastomotic leakage after esophagectomy with subcutaneous gastric conduit reconstruction after neoadjuvant chemoradiotherapy. Various procedures including debridement, resuturing the anastomotic leakage site and filling with a polyglycolic acid sheet were performed to control the enterocutaneous fistulae without success. NPWT was initiated in both cases, and both of them healed completely. NPWT is considered to be useful for intractable enterocutaneous fistulae, as it promotes granulation tissue formation and enhances wound healing by providing tightfitting wound surface with negative pressure and blocking leakage of the digestive juices, such as saliva.