AORTO ESOPHAGEAL FISTULA AFTER MINIMALLY INVASIVE ESOPHAGECTOMY WITH INTRATHORACIC ANASTOMOSIS: REPORT OF 3 CASES
STEFANUS J. VAN ROOIJEN *
Department of Surgery, Canisius Wilhelmina Hospital, Netherlands
FRANS VAN WORKUM
Department of Surgery, Canisius Wilhelmina Hospital, Netherlands
BART A. P. M. BOLL
Department of Surgery, Canisius Wilhelmina Hospital, Netherlands
HEIDI RÜTTEN
Department of Radiotherapy, Radboud University Medical Center, Netherlands
HAN BONENKAMP
Department of Surgery, Radboud University Medical Center, Netherlands
CAMIEL ROSMAN
Department of Surgery, Canisius Wilhelmina Hospital, Netherlands
*Author to whom correspondence should be addressed.
Abstract
Aorto Esophageal Fistula (AEF) is a rare and fatal condition. No reports arepublished concerning AEF after minimally invasive esophagectomy (MIE) for esophageal cancer.
We describe three cases with AEF as a complication of MIE with intrathoracic esophagogastricanastomosis (IEA) and performed a review of the literature.
Patients presenting shortly after MIE and (IEA) with acute onset of hematemesis should be suspectedof having an AEF. Anastomosis leakage, inflammation, radiotherapy and even chyle leakage couldcontribute to AEF development, but the direct cause remains unknown. The shift of cervicalesophagogastric anastomosis (CEA) to IEA could be associated with a higher incidence of AEF after MIE.
This is the first review reported about AEF after MIE with IEA that includes the report of onesurviving patient. Diagnostic and treatment possibilities are discussed but results are poor. Earlydiagnosis and prompt treatment with endovascular stenting or surgery are currently the only way ofsurvival.
Keywords: Esophageal cancer, Esophageal surgery, Fistula Aorta/aortic surgery, complications, Upper GI bleeding