Surgical cervicothoracic-flap repair of neoesophagus-airway fistula after esophagectomy for esophageal cancer: A retrospective cohort study.
JTCVS Tech
; 23: 123-131, 2024 Feb.
Article
em En
| MEDLINE
| ID: mdl-38351987
ABSTRACT
Objective:
To evaluate outcomes of surgical repair of postesophagectomy neoesophagus-airway fistulas (NEAFs).Methods:
We retrospectively included consecutive patients with NEAF managed by various techniques at our center between August 2009 and July 2021.Result:
Of the 11 patients (median age, 60 years; interquartile range, 58, 62), 4 had received induction chemoradiotherapy and 4 others induction chemotherapy. NEAF was mainly a complication of anastomotic leakage (n = 6) or attempted stenosis treatment (n = 3). The airway mainly involved was the trachea (n = 8). Airway defects were repaired by resection-anastomosis (n = 5), perforator flaps (n = 4), pedicled pericardium (n = 1), and/or direct suturing (n = 2). Gastric conduit defects were repaired by perforator flaps (n = 6), direct suturing (n = 2), or pedicled pericardium (n = 1). Of the 7 perforator flaps, 4 were internal mammary-artery, two dorsal intercostal-artery, and one supraclavicular-artery flaps. After a median follow-up of 100 months, 2 patients died on early postoperative course from NEAF repair failure and 3 from late NEAF recurrence at 4, 11, and 33 months. Among the remaining 6 patients, 1 died from local tumoral recurrence at 13 months, 1 was last on follow-up at 27 months, alive and eating normally. The other 4 were free from NEAF recurrence and dysphagia or swallowing disorder at 50 months' follow-up. These 4 results were obtained thanks to perforator flap interposition and airway resection anastomosis.Conclusions:
Surgical NEAF repair using perforator flap interposition may provide satisfactory long-term function after strong prehabilitation.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Etiology_studies
/
Observational_studies
Idioma:
En
Revista:
JTCVS Tech
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
França