Staged repair of benign tracheo-neo-esophageal fistula 12 years after esophagectomy for esophageal cancer.

Abstract

Benign tracheo-neo-esophageal fistula is a rare complication after esophagectomy. We report a 60-year-old man who presented 12 years after a McKeown esophagectomy with a fistula between the tracheal carina and the gastric conduit. In view of his severe sepsis and profound malnutrition, he underwent placement of a silicon Y-stent with a successful three-stage surgical repair consisting of duodenal exclusion with drainage gastrostomy. Six weeks later, the patient had closure of the fistula through a right thoracotomy. He finally underwent Roux-en-Y gastro-jejunostomy through a left thoraco-abdominal approach to restore the gastrointestinal continuity. Eighteen months postoperatively, he reports no dysphagia and has regained his premorbid weight.