Long-term results of surgical treatment in benign bronchoesophageal fistula

J Thorac Cardiovasc Surg. 2007 Aug;134(2):411-4. doi: 10.1016/j.jtcvs.2007.04.030.

Abstract

Objectives: Benign bronchoesophageal fistula is a rare complication resulting from various diseases. The objectives of the study are to report our surgical experience in patients with benign bronchoesophageal fistulas and to evaluate the long-term results of surgical management.

Methods: Between 1995 and 2005, a total of 14 patients (mean age, 52.5 years; male/female = 6:8) underwent operations for benign bronchoesophageal fistulas. The etiology of the fistulas included traction esophageal diverticula in 7 patients and tuberculous lymphadenopathy in 6. Primary repair of the fistula was performed in all patients and a concomitant lobectomy in 6.

Results: There was no in-hospital mortality. Postoperative complications occurred in 1 patient (empyema resulting from a leakage at the repair site). Postoperative esophagography revealed a leakage at the repair site in 1 patient. There was 1 late death with a mean follow-up of 43.9 months. The cause of death was aspiration pneumonia resulting from recurrent fistula. Two of 8 patients who did not undergo a lobectomy had persistent bronchiectasis, whereas none of those who underwent a concomitant lobectomy had any recurrent pneumonia or bronchiectasis. The overall survival was 100% at 5 years and the mean survival time was 124 months (95% confidence interval, 106.5-142.2 months).

Conclusions: We conclude from these data that early detection and definitive surgical repair of benign bronchoesophageal fistulas can yield high success rates with excellent early outcomes and good long-term results.

MeSH terms

  • Adult
  • Aged
  • Bronchial Fistula / surgery*
  • Bronchoscopy
  • Esophageal Fistula / surgery*
  • Esophagoscopy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Survival Rate
  • Treatment Outcome