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Respiratory Medicine

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Endoscopic closure of acquired oesophagorespiratory fistulas with cardiac septal defect occluders or vascular plugs - 30/07/15

Doi : 10.1016/j.rmed.2015.04.014 
Jing Li a, 1 , Xinglin Gao a, 2 , Jingjing Chen a, 3 , Miaochan Lao b, 4 , Shushui Wang c, 5 , Guohong Zeng c, ⁎
a Respiratory Department, Guangdong Geriatrics Institute and Guangdong General Hospital, Guangdong, 510080, China 
b Respiratory Department, Guangdong Academy of Medical Sciences and Guangdong General Hospital, Guangdong, 510080, China 
c Dept. of Pediatric Cardiology, Guangdong Cardiovascular Institute and Guangdong General Hospital, Guangdong, 510080, China 

∗Corresponding author. Tel.: +86 020 83845152; fax: +86 020 83827712.

Summary

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.

El texto completo de este artículo está disponible en PDF.

Keywords : Acquired oesophagorespiratory fistulas, Cardiac septal defect occluders, Vascular plugs, Flexible bronchoscope, Stent, Aspirated pneumonia


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Vol 109 - N° 8

P. 1069-1078 - août 2015 Regresar al número
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