Fistula closure technique using an esophageal stent and fixation method for gastrointestinal-airway fistula after esophageal cancer surgery.

BACKGROUND

The occurrence of a gastrointestinal-airway fistula after esophageal cancer surgery is a serious and fatal complication that can cause severe respiratory complications. It is a pathological condition requiring prompt intervention to avoid a fatal course. Conventionally, highly invasive surgical treatment has been selected for the treatment for gastrointestinal-airway fistula, but its difficulty and mortality risk cannot be neglected. Esophageal stent placement is useful as a nonoperative management for gastrointestinal-airway fistulas, but the success rate of fistula closure is not that high. Hence, an effective method that can solve technical problems to avoid intervention-related complications and increases the success rate of fistula closure by stent placement needs to be developed. We have achieved better results with our unique ingenuity for the management of esophageal stent placement; thus, we aimed to describe the details of the management methods.

METHODS

Our technique used in stent placement included endoscopic insertion of the self-expandable metallic stent and the fixation of the stent with a nylon thread and a transnasal catheter on the face. With this ingenuity, it becomes possible to reduce stent migration, and an easy and quick adjustment of its position in case of stent migration can be possible.

RESULTS

We have experienced successfully cured cases with our novel technique [five of seven cases (71.4%)] with a minimum indwelling period.

CONCLUSIONS

Our technique is feasible for use in the management of gastrointestinal-airway fistula after esophageal cancer surgery.