PubMed · 6051438
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H T Langston, W L Barker, A A Graham. 1967. Pleural tuberculosis.. https://pubmed.ncbi.nlm.nih.gov/6051438/
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OBJECTIVE: To compare the results of plastic endoprostheses and of self expanding stents in patients with an esophagobronchial fistula. DESIGN: Retrospective, descriptive. SETTING: Nederlands Kanker Instituut/Antoni van Leeuwenhoek Ziekenhuis, Amsterdam, the Netherlands. METHOD: Forty-two patients with an esophagobronchial fistula caused by a malignant tumour in the oesophagus, lungs or mediastinum were fitted with an endoprosthesis during the period 1 January 1991-31 August 1995. Use was made initially of a plastic endoprosthesis with a special tulip funnel (n = 24), later of a coated self expanding stent (n = 18). In seven patients, the fistula had been the first manifestation of the tumour; in 35, a recurrence after earlier treatment was involved. The initial characteristics (sex, age, diagnosis, earlier therapy, signs and symptoms) were the same in both groups. RESULTS: Dilatation immediately before insertion of a plastic endoprosthesis was necessary in 23 patients (96%); such dilatation was necessary in four of the patients (22%) fitted with a self expanding stent. Complete sealing of the fistula was achieved in 19 (79%) and 15 (83%) patients, respectively. Reoperations were necessary in eight (33%) and three (17%) patients. Early major complications occurred in four (17%) and two (11%) patients. CONCLUSION: The selfexpanding stent was faster and easier to insert than a plastic endoprosthesis, and effective in sealing an oesophagobronchial fistula.
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We reported a successfully treated case of empyema with a large tracheal fistula after subtotal esophagotomy. This 59-year-old male was treated by drainage with mediastinoscopy and repeated wash-out under bronchoscopy, because we could not use the omentum and he was the poor-risk patient. The trancheal fistula was obliterated bronchoscopically, 4 months after the mediastinoscopy. We believe that this method (abscess drainage with mediastinoscope and wash-out repeatedly) is useful for those who has broncheal fistula after esophagectomy.