Analysis Of 19 Cases Of Esophagotracheal Fistula After Surgery For Esophageal Cancer

Objective: Retrospective study of 19 cases of esophagotracheal fistula after esophageal cancer.Clinical data: The clinical data of 19 patients with esophagotrachea l fistula after esophageal cancer surgery in the fourth hospital of hebei medical university from January 2011 to January 2018 were reviewed.A mong the 19 patients in this group,10 were males and 9 were females,aged 51-70 years,with an average age of 61.7 years.Eighteen cases we re squamous cell carcinoma and one was adenosquamous carcinoma.Am ong them,there were 3 cases of upper thoracic segment esophageal,13 cases of middle thoracic segment esophageal,and 3 cases of lower tho racic segment esophageal.Esophagogastric neck anastomosis was found in 8 cases and intrathoracic anastomosis in 11 cases.Esophagotracheal fistu la occurred at the earliest postoperative day 7,the latest postoperative d ay 93 d,and the median postoperative day 19 d.All the 19 patients receiv ed conservative treatment,including water fasting,gastrointestinal decom pression,anti-infection,nutritional support,and unobstructed drainage.Am ong them,11 cases were treated with simple conservative treatment,6 c ases healed,3 cases died due to infection,1 case died due to poor nutr ition,and 1 case survived with fistula for 16 months.4 cases were treat ed with tracheal stent implantation,2 cases were healed,the other 2 die d of hemoptysis and infection respectively.2 cases were treated with eso phageal stent implantation,1 case was healed,and 1 case died of hemo ptysis.One case was treated with titanium clip to close esophageal fistul a.The other one was treated with tracheal stent combined with surgery.A fter treatment,10 of the 19 patients were healed within 15 d ~ 224 d an d the median healing time was 58 d.Conclusion:1.Tracheal fistula may mainly occur in the chest,and esophageal fistula is mainly located at the anastomotic stoma and residual stomach.2.Esophagotracheal fistula after esophageal cancer surgery is based on nutritional support.Adequate drainage is the key,and infection control is the most important.3.Patients with esophagotracheal fistula can die from infection,bleeding and poor nutrition.4.For intrathoracic anastomosis and cervical anastomosis,there may be no statistical difference in the proportion of esophageal and tracheal fistula to esophageal fistula.