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Endoscopic closure of acquired oesophagorespiratory fistulas with cardiac septal defect occluders or vascular plugs.

Abstract：

OBJECTIVES:To report an endoscopic treatment for inoperable oesophagorespiratory fistulas (ORFs). PATIENTS AND METHODS:Six patients with inoperable acquired tracheobronchial-oesophageal fistulas (four males and two females; mean age, 70.2 ± 10.28 years) were included. Cardiac septal defect occluders or vascular plugs were implanted through a flexible bronchoscope to close the ORFs. Monthly follow-ups were done for 16 months. RESULTS:All fistulas were successfully closed immediately after the procedure. The severe aspirated pneumonia was controlled in 7-10 days. The two mechanically ventilated patients were weaned successfully from the ventilator, and the general condition of patients improved rapidly. However, the fistulas recanalised in four patients because of the cutting effect of the edge of the occluders 1-12 months after the procedure. Other reasons, such as compression of the tracheal intubation balloon and repeated inflammation of the oesophageal diverticulum, may also have contributed to the recanalisation. CONCLUSIONS:Endoscopic closure of acquired ORFs with cardiac septal defect occluders or vascular plugs improve patients' general condition immediately after the procedure, but may result in recanalisation longterm. The occlusion might be considered an abridgement to surgery.

journal_name

Respir Med

journal_title

Respiratory medicine

authors

Li J,Gao X,Chen J,Lao M,Wang S,Zeng G

doi

10.1016/j.rmed.2015.04.014

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

1069-78

issue

8

eissn

0954-6111

issn

1532-3064

pii

S0954-6111(15)00145-6

journal_volume

109

pub_type

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