Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
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Clinical Trial
Respiratory management and outcome of non-malignant tracheo-bronchial fistula following esophagectomy.
Tracheo-bronchial lesions with air leak are rare but a catastrophic complications of esophageal resections. We analyzed the management and outcome of 31 patients who developed a non-malignant lesion of the trachea or main stem bronchus after esophagectomy for esophageal cancer. All patients initially required endotracheal intubation to control respiratory distress. ⋯ Ten of the 31 patients (33%) died during the postoperative course, in eight out of 10 patients, postoperative mortality resulted from an unhealed lesions at the bifurcation or in the left main stem bronchus. These data show that reduction of airway pressure and spontaneous breathing are the key to closure of the airway leak. The entire armamentarium of respiratory, bronchoscopic, and surgical techniques must be available for a successful management of these patients.