Aortoesophageal fistula (AEF) is a relatively rare and usually fatal disease, with no established treatment at present.
We recently successfully treated a patient with esophagectomy and a latissimus dorsi muscle transfer for AEF following thoracic endovascular aortic repair (TEVAR).
In treating AEF, prevention of fatal bleeding and infection is important. To prevent fatal bleeding, TEVAR has recently gained recognition as an initial emergent treatment. In addition, prevention of continuous contamination through the fistula has utilized omental flap coverage, as reported in several papers.
However, an omental flap was not available for our patient, because he was scheduled for gastrectomy due to gastric cancer.
Therefore, we decided to use a latissimus dorsi muscle flap to cover the fistula, because it has a rich blood supply, sufficient length to reach the fistula, and adequate volume to cover the entire fistula.
The postoperative course was uneventful, and the patient was discharged about six months after being admitted.
Accordingly, we feel that a latissimus dorsi muscle transfer is useful for the treatment of AEF when an omental flap is unavailable because of laparotomy or gastrectomy.

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Negative pressure wound therapy (NPWT) has been introduced as a useful technique for wound treatment. However, some complications have been reported, such as infection, bleeding and pain, which make it impossible for patients to continue further treatment. Air leak is another problem, especially in hairy regions, such as the head and genital area. We have introduced a silicone gel adhesive dressing for NWPT, instead of using the film included in the original kit. The use of the silicone gel adhesive dressing greatly reduces pain, which was occurs when detaching the film. In addition, it plays a role in reducing air leak in hairy regions. Although there remains the problem of its high cost, silicone gel adhesive dressing for NPWT is quite useful.

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