Surgical management of acquired tracheo/bronchoesophageal fistula associated with esophageal diverticulum

Abstract

Background: The reports on acquired tracheoesophageal fistulas (TEFs) or bronchoesophageal fistulas (BEFs) associated with traction esophageal diverticula (TED) are rare. Here, we present our experience of six cases. Methods: Between Jan. 2015 and Jun. 2016, 6 patients were admitted to our department for TEF/BEFs combined with esophageal diverticula. Clinical data of the 6 patients were retrospectively reviewed. Results: All orifices of TEF/BEF in the esophagus side opened at the diverticula wall. The orifices in the airway side were 2 at the carina and 4 at the right intermediate bronchus. All six patients received the same intervention: a limited diverticulectomy with the fistula resection was done in the esophagus; separate layers of repair were performed for the defect in the esophagus; the muscle flap interposition was used in all six cases. All postoperative courses were uneventful. No recurrence fistula and symptomatic diverticula occurred. The airway and esophagus were patency during a median of 9-month follow-up. Conclusions: Acquired TEF/BEFs caused by esophageal diverticula can be treated successfully by surgery. A limited diverticulectomy is sufficient to ensure enough esophagus remodeling.