Benign Bronchoesophageal Fistula in Adults: Endoscopic Closure as Primary Treatment
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Background/Aims: Benign bronchoesophageal fistula (BEF) is a rare condition that is usually treated surgically;however, less invasive endoscopy procedures have been attempted to overcome the disadvantages of surgery. The aim of this study was thus to determine the results of endoscopic management as a primary treatment in patients with BEF. Methods: We retrospectively analyzed data from 368 patients with BEF who were treated at a tertiary care, academic medical center between January 2000 and August 2009. Results: Benign causes were found for only 18of the 368 patients. Of these, seven were treated endoscopically and the others by surgery or other methods. The first endoscopy procedures failed in all seven patients, with second trials of endoscopy performed in four patients at a median of 8 days (range,3 to 11 days) after the first procedure. The second endoscopic procedure was successful in two out of four patients; one patient showed no recurrence of the fistula, whereas the second patient experienced a recurrence after 24 months. All patients underwent successful surgical procedures after the failure of endoscopic treatment, with no further recurrences. Conclusions: Although we observed a low rate of success for primary endoscopic treatment of benign BEF, the invasive nature of surgery suggests the need for a prospective study with a large number of patients to evaluate the efficacy of less invasive procedures such as endoscopic treatment.
Abstract
Background/Aims: Benign bronchoesophageal fistula (BEF) is a rare condition that is usually treated surgically;however, less invasive endoscopy procedures have been attempted to overcome the disadvantages of surgery. The aim of this study was thus to determine the results of endoscopic management as a primary treatment in patients with BEF. Methods: We retrospectively analyzed data from 368 patients with BEF who were treated at a tertiary care, academic medical center between January 2000 and August 2009. Results: Benign causes were found for only 18of the 368 patients. Of these, seven were treated endoscopically and the others by surgery or other methods. The first endoscopy procedures failed in all seven patients, with second trials of endoscopy performed in four patients at a median of 8 days (range,3 to 11 days) after the first procedure. The second endoscopic procedure was successful in two out of four patients; one patient showed no recurrence of the fistula, whereas the second patient experienced a recurrence after 24 months. All patients underwent successful surgical procedures after the failure of endoscopic treatment, with no further recurrences. Conclusions: Although we observed a low rate of success for primary endoscopic treatment of benign BEF, the invasive nature of surgery suggests the need for a prospective study with a large number of patients to evaluate the efficacy of less invasive procedures such as endoscopic treatment.
참고문헌 (17)
- Woods D, "Benign, atraumatic, bronchoesophageal fistulae", Can Assoc Radiol J, 39, pp.68~71 (1988)
- Lado Lado FL, "Bronchoesophageal fistulae secondary to tuberculosis", Respiration, 69, pp.362~365 (2002)
- Mangi AA, "Benign broncho-esophageal fistula in the adult", Ann Thorac Surg, 73, pp.911~915 (2002)
- Murdock A, "Closure of a benign bronchoesophageal fistula with endoscopic clips", Gastrointest Endosc, 62, pp.635~638 (2005)
- Griffo S, "Benign bronchoesophageal fistula: report of four cases", J Thorac Cardiovasc Surg, 133, pp.1378~1379 (2007)
- Kim HK, "Long-term results of surgical treatment in benign bronchoesophageal fistula", J Thorac Cardiovasc Surg, 134, pp.411~414 (2007)
- Smith DC, "A congenital broncho-oesophageal fistula presenting in adult life without pulmonary infection", Br J Surg, 58, pp.398~400 (1970)
- Kohler B, "Spontaneous esophagotracheal fistula resulting from ulcer in heterotopic gastric mucosa", Gastroenterology, 95, pp.828~830 (1988)
- Mizobuchi S, "Endoscopic clip application for closure of an esophagomediastinal-tracheal fistula after surgery for esophageal cancer", Gastrointest Endosc, 57, pp.962~965 (2003)
- Ogunmola N, "Endoscopic closure of esophagobronchial fistula with fibrin glue", J Pediatr Gastroenterol Nutr, 38, pp.539~541 (2004)
- Scappaticci E, "Closure of an iatrogenic tracheo-esophageal fistula with bronchoscopic gluing in a mechanically ventilated adult patient", Ann Thorac Surg, 77, pp.328~329 (2004)
- Kim JH, "Congenital bronchoesophageal fistulas in adult patients", Ann Thorac Surg, 60, pp.151~155 (1995)
- Ramo OJ, "Congenital bronchoesophageal fistula in the adult", Ann Thorac Surg, 59, pp.887~889 (1995)
- Cherveniakov A, "Acquired benign esophago-airway fistulas", Eur J Cardiothorac Surg, 10, pp.713~716 (1996)
- Van Natta TL, "Benign esophagobronchial fistula with and without esophageal obstruction: two ends of the surgical spectrum", Ann Thorac Surg, 85, pp.322~325 (2008)
- Raijman I, "Endoscopic management of esophagorespiratory fistulas: expanding our options with expandable stents", Am J Gastroenterol, 93, pp.496~499 (1998)
- Dumonceau JM, "Esophageal fistula sealing: choice of stent, practical management, and cost", Gastrointest Endosc, 49, pp.70~78 (1999)