The classification and treatment strategies of post-esophagectomy airway-gastric fistula

doi:10.21037/jtd-20-284

HFCAS OpenIR

	The classification and treatment strategies of post-esophagectomy airway-gastric fistula
	Wang, Changchun 1,2; Li, Chengqiang 3; Yang, Xun 1,2; Mao, Weimin 1,2; Jiang, Youhua 1,2; Wu, Jie 1,2; Zhao, Qiang 1,2; Ji, Anqi 3; Chen, Qixun 1,2; Li, Hecheng 3; Liu, Jinshi 1,2
	2020-07-01
发表期刊	JOURNAL OF THORACIC DISEASE
ISSN	2072-1439
通讯作者	Li, Hecheng(lihecheng2000@hotmail.com) ; Liu, Jinshi(liujinshi208@163.com)
摘要	Background: Airway-gastric fistulas (AGFs) are rare but life-threatening complications after esophagectomy for esophageal cancer. Their effective and reasonable management is challenging and still controversial. This study reports the classification and management strategies of post-esophagectomy AGF based on a retrospective analysis of 26 cases in two large volume centers in China. Methods: Between January 2000 and December 2017, 6,316 consecutive patients with esophageal carcinoma underwent esophagectomy. AGF was verified in 26 patients. The patients with AGF were divided into two types based on the anatomic characteristics of the fistula. Type I was characterized by the presence of fistula orifices in digestive tract that were higher than those in the airway and were treated with conservative management. Type II had both fistula orifices located on the same horizontal plane and were treated with surgical management. Pearson Chi-Square (R software) was used to compare mortality rates. Results: From January 2000 and December 2017, 26 cases occurred AGF in 6,316 consecutive patients with esophageal carcinoma underwent esophagectomy and the incidence of AGF was 0.4%. Ten of 12 patients with type I AGF survived. Nine of 14 patients with type II AGF died. There was a significantly difference in the mortality rates between patients with AGF type I and II, which was 16.7% (2/12) and 64.3% (9/14) (chi(2)=6.003, P=0.014), respectively. Conclusions: AGF may be classified into two types according to the anatomic characteristics. Type I patients may be cured by conservative management and type II patients, require surgical intervention with pedicled tissues flap wrapping of the airway.
关键词	Airway-gastric fistula (AGF) esophagectomy esophageal cancer classification management strategy
DOI	10.21037/jtd-20-284
关键词[WOS]	TRACHEOBRONCHIAL FISTULA ; BRONCHOESOPHAGEAL FISTULA ; MANAGEMENT
收录类别	SCI
语种	英语
资助项目	National Key Research and Development Program of China[2017YFC0113500] ; Medical and Health of Zhejiang Province Scientific Research Project[2014KYA101] ; Medical and Health of Zhejiang Province Scientific Research Project[2013KYA031] ; Zhejiang Provincial Natural Science -Mathematical Medicine Association Joint Fund[LSY19H160001]
项目资助者	National Key Research and Development Program of China ; Medical and Health of Zhejiang Province Scientific Research Project ; Zhejiang Provincial Natural Science -Mathematical Medicine Association Joint Fund
WOS研究方向	Respiratory System
WOS类目	Respiratory System
WOS记录号	WOS:000553789500020
出版者	AME PUBL CO
引用统计	被引频次：9[WOS] [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	http://ir.hfcas.ac.cn:8080/handle/334002/70892
专题	中国科学院合肥物质科学研究院
通讯作者	Li, Hecheng; Liu, Jinshi
作者单位	1.Univ Chinese Acad Sci, Zhejiang Canc Hosp, Canc Hosp, Dept Thorac Surg, Hangzhou, Peoples R China 2.Chinese Acad Sci, Inst Canc & Basic Med IBMC, Hangzhou, Peoples R China 3.Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Dept Thorac Surg, Shanghai, Peoples R China
推荐引用方式 GB/T 7714	Wang, Changchun,Li, Chengqiang,Yang, Xun,et al. The classification and treatment strategies of post-esophagectomy airway-gastric fistula[J]. JOURNAL OF THORACIC DISEASE,2020,12.
APA	Wang, Changchun.,Li, Chengqiang.,Yang, Xun.,Mao, Weimin.,Jiang, Youhua.,...&Liu, Jinshi.(2020).The classification and treatment strategies of post-esophagectomy airway-gastric fistula.JOURNAL OF THORACIC DISEASE,12.
MLA	Wang, Changchun,et al."The classification and treatment strategies of post-esophagectomy airway-gastric fistula".JOURNAL OF THORACIC DISEASE 12(2020).