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Chirurgie 6. August 2015

“Rendez-vous” over-the-scope endoclipping for tracheoesophageal fistula: case report and review of the literature

Background: Management of tracheoesophageal fistula is challenging and is associated with high morbidity and mortality. Malignancy and cuff-related tracheal decubitus are the most common causes of tracheoesophageal fistula. Open surgical division and closure of the fistula orifices with or without tissue interposition has represented the standard of care for decades. Endoscopic management of tracheoesophageal fistula is still debated and only a few cases have been described in the literature.

Methods: A 57-year-old male patient with chronic tracheoesophageal fistula occurring 1 year after esophagectomy for squamous-cell carcinoma was treated with a “rendez-vous” over the scope endoclipping technique using the OVESCO R system. The pertinent literature on the topic has been reviewed and compared to the present case.

Results: The patient was discharged home on postoperative day 6 on a semisolid diet and remains asymptomatic at 5 month follow-up.

Conclusions: The OVESCO R system seems to be safe and effective in the treatment of small tracheoesophageal fistula.

A. Aiolfi, D. Bona, C. Ceriani, G. Saino, L. Bonavina, European Surgery 4/2015

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