Interventional endoscopic treatments including the application of glue are becoming more frequently used for the treatment of esophageal fistulas. However, there are no prospective studies of endoscopic treatment for esophageal fistulas. This prospective study aims to investigate the efficacy and safety of endoscopic injection of alpha-cyanoacrylate monomer for intractable esophageal fistulas. This single-center prospective phase II trial included patients with more than 1 wk of conservative medical treatment for intractable esophageal fistulas after esophagectomy. In the image-guided therapy suite, a mixture of alpha-cyanoacrylate monomer and oily contrast agent in a ratio of 0.3 to 1.7 mL was endoscopically injected through the fistula. Twenty-five patients who underwent esophagectomy at Wakayama Medical University Hospital were enrolled in this study. The primary disease was esophageal cancer in 16 patients (64 %) and gastric cancer in the remaining 9 patients (36 %). Complete closure of the esophageal fistula was performed in 22 patients after endoscopic injection of alpha-cyanoacrylate monomer. The overall success rate was 88 %. There was no fistula recurrence in any successful closure cases. Three patients with failed esophageal fistula closure had esophageal cancer with cervical esophageal fistulas and required reoperation of the fistulectomy under general anesthesia. No complications associated with this endoscopic treatment were detected. Endoscopic treatment with injection of alpha-cyanoacrylate monomer facilitated healing of post-esophagectomy fistula in 88 % of patients without complications. This suggests that the treatment is effective and safe for patients with esophageal fistulas.
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http://dx.doi.org/10.1055/a-0581-9005 | DOI Listing |
J Pediatr Surg
January 2025
Congenital Oesophageal and Airway Team Utrecht, Departments of Paediatric Surgery and Otorhinolaryngology and Head and Neck Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.
Introduction: Recurrent Tracheoesophageal Fistula (rTEF) is a complication of Esophageal Atresia (EA) that can lead to severe respiratory symptoms. RTEF can be corrected via endotracheal treatment (ET) or surgical treatment (ST). The efficacy of these techniques varies in literature.
View Article and Find Full Text PDFPediatr Surg Int
January 2025
Department of Pediatric Surgery, Cleveland Clinic Children's Hospital, 8950 Euclid Avenue, Mail Code R3, Cleveland, OH, 44106, USA.
Background: Long-gap esophageal atresia (LGEA) can complicate the management of esophageal atresia (EA) with or without a tracheoesophageal fistula (TEF). This series describes a short interval, staged, thoracoscopic internal traction approach for LGEA with distal TEF to manage complex anastomotic tension or an anatomically impossible esophageal anastomosis.
Methods: A retrospective review (2018-2024) was performed across four tertiary centers to identify patients with LGEA and distal TEF, managed with a staged, thoracoscopic internal traction approach.
Oxf Med Case Reports
January 2025
Internal Medicine, Grandview Medical Center, 3690 Grandview Parkway, Birmingham, AL 35243, United States.
Purulent bacterial pericarditis is a rare and progressive infection with a high mortality. It is rarely due to , a commensal bacteria found in the oral cavity, gastrointestinal tract, and the genitourinary tract. Here we present a 71-year-old man with history of esophageal adenocarcinoma, status post distal esophagectomy and proximal gastrectomy 2 years prior, who developed cardiac tamponade secondary to primary purulent bacterial pericarditis in the absence of an esophago-pericardial fistula.
View Article and Find Full Text PDFBMC Surg
January 2025
Department of Neonatal Surgery, National Center for Children's Health, Beijing Children Hospital, Capital Medical University, 56 Nanlishi Road, Beijing, 100045, China.
Background: In select patients with type C esophageal atresia, primary anastomosis is not appropriate and a staged approach is required. We aim to summarize our experience in the management of type C EA using a staged approach.
Methods: A retrospective chart-review of patients with type C EA admitted to Beijing Children's Hospital between July 2020 to October 2023 were conducted.
Medicine (Baltimore)
January 2025
Gastroenterology, Chongqing University Cancer Hospital, Chongqing, China.
Rationale: Aortoesophageal fistula (AEF) is an exceedingly rare yet critically life-threatening condition, with mortality rates nearing 100% if not addressed promptly. AEF often develops in the context of thoracic aortic aneurysms, esophageal malignancies, or as a complication of foreign body ingestion and prior thoracic aortic surgeries. This study reports an exceptionally severe and clinically rare case of AEF associated with a pseudaneurysm induced by esophageal stenting.
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