Clinical efficacy of stapler technique for repair of cervical tracheoesophageal fistula_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Jinzhou ^1,2 , YANG Jianbao ¹ ,  LI Bin ¹ , ZHANG Jianhua ¹ , JIANG Peng ¹ , SONG Tieniu ¹ , WEI Xiaoping ¹ , ZHU Duojie ¹ , MENG Yuqi ¹ , GUO Quanwei ¹

1. Department of Thoracic Surgery, Lanzhou University Second Hospital, Lanzhou UniversitySecond Clinical Medical College, Lanzhou, 730030, P.R.China;
2. Intensive Care Unit, Gansu Provincial Hospital, Lanzhou, 730000, P.R.China;

Corresponding author：

LI Bin, Email: dr.leebin@outlook.com

Keywords：

Cervical tracheoesophageal fistula; stapler technique; efficacy analysis

DOI：

10.7507/1007-4848.201703023

Video：

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Objective To evaluate the clinical efficacy of fistula repair by stapler technique in patients with cervical tracheoesophageal fistula. Methods Retrospective analysis of 8 patients with cervical tracheoesophageal fistula who accepted operative treatment in the Department of Thoracic Surgery, Lanzhou University Second Hospital from October 2014 to October 2016 was conducted. There were 5 males and 3 females at a mean age of 46.4±13.9 years ranging from 23 to 67 years. The fistula was induced by tracheal intubation in 4 patients, by esophageal foreign bodies in 2, by tracheal stent in 1 and by esophageal diverticulum in 1. The fistula was closed by stapler technique. The surgical effects were evaluated through Karnofsky performance score (KPS), image assessment, patient satisfaction score and assessment of improvement in feeding-induced bucking. Results The operations were performed successfully with time of 117.5±6.6 min and intraoperative blood loss of 60.0±7.0 ml. After the operations, the patients did not suffer incision bleeding and infection, hoarseness, dyspnea, drinking-induced bucking, fistula relapse, tracheoesophageal stenosis or any other complications, and no death occurred during the perioperative period. The chest X-ray test was performed 1 week later showed that the pulmonary infection disappeared, and only 1 patient suffered from esophageal stenosis 1 year later. The postoperative KPS score was 90.0±7.0 points, which significantly improved in contrast to preoperation (P<0.01). Postoperative pulmonary infection area reduced significantly (P<0.05), tracheoesophageal fistula disappeared, postoperative patients satisfaction rate was 90%, and assessment of feeding-induced bucking was excellent. Conclusion Using stapler technique to repair cervical tracheoesophageal fistula is safe, easy and useful, with less operation time and postoperative complications.

Citation： ZHANG Jinzhou, YANG Jianbao, LI Bin, ZHANG Jianhua, JIANG Peng, SONG Tieniu, WEI Xiaoping, ZHU Duojie, MENG Yuqi, GUO Quanwei. Clinical efficacy of stapler technique for repair of cervical tracheoesophageal fistula. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(2): 153-158. doi: 10.7507/1007-4848.201703023 Copy

1.	Piastra M, Briganti V, Luca E, et al. Recurrent tracheoesophageal fistula and respiratory failure: the role of early airway endoscopic approach. Eur J Pediatr Surg, 2013, 23(2): 153-156.
2.	Mohsin M, Saleem Mir I, Hanief Beg M, et al. Nasogastric tube knotting with tracheoesophageal fistula - a rare association. Interact Cardiovasc Thorac Surg, 2007, 6(4): 508-510.
3.	Qadeer MA, Dumot JA, Vargo JJ, et al. Endoscopic clips for closing esophageal perforations: case report and pooled analysis. Gastrointest Endosc, 2007, 66(3): 605-611.
4.	Parlak E, Dişibeyaz S, Köksal AS, et al. A new approach to gastrointestinal fistula closure: endoloop and clips technique using double endoscope. Eur J Gastroenterol Hepatol, 2012, 24(4): 464-467.
5.	Tran C, Fink DS, Kunduk M, et al. Minimally invasive management of tracheoesophageal fistula with T-tube. Laryngoscope, 2015, 125(8): 1911-1914.
6.	Chen YH, Li SH, Chiu YC, et al. Comparative study of esophageal stent and feeding gastrostomy/jejunostomy for tracheoesophageal fistula caused by esophageal squamous cell carcinoma. PLoS One, 2012, 7(8): e42766.
7.	Rakoczy G, Brown B, Barman D, et al. KTP laser: an important tool in refractory recurrent tracheo-esophageal fistula in children. Int J Pediatr Otorhinolaryngol, 2010, 74(3): 326-327.
8.	Sung MW, Chang H, Hah JH, et al. Endoscopic management of recurrent tracheoesophageal fistula with trichloroacetic acid chemocauterization: a preliminary report. J Pediatr Surg, 2008, 43(11): 2124-2127.
9.	Briganti V, Coletta R, Giannino G, et al. Usefulness of dextranomer/hyaluronic acid copolymer in bronchoscopic treatment of recurrent tracheoesophageal fistula in children. Int J Pediatr Otorhinolaryngol, 2011, 75(9): 1191-1194.
10.	Czymek R, Keller R, Hildebrand P, et al. Does the third staple line of a new endostapler offer an advantage?. Zentralbl Chir, 2009, 134(3): 254-259.
11.	Ban D, Shimada K, Konishi M, et al. Stapler and nonstapler closure of the pancreatic remnant after distal pancreatectomy: multicenter retrospective analysis of 388 patients. World J Surg, 2012, 36(8): 1866-1873.
12.	Lustosa SA, Matos D, Atallah AN, et al.Stapled versus hand-sewn methods for colorectal anastomosis surgery: a systematic review of randomized controlled trials.Sao Paulo Med J, 2002, 120( 5): 132-136.
13.	Smart CJ, Jones L. Use of Echelon 60 ENDOPATH stapling device in open ileal pouch anal anastomosis (IPAA) surgery. Colorectal Dis, 2009, 11(9): 989.
14.	Diener MK, Seiler CM, Rossion I, et al. Efficacy of stapler versus hand-sewn closure after distal pancreatectomy (DISPACT): a randomised, controlled multicentre trial. Lancet, 2011, 377(9776): 1514-1522.
15.	Asakura K, Izumi Y, Kohno M, et al. Effect of cutting technique at the intersegmental plane during segmentectomy on expansion of the preserved segment: comparison between staplers and scissors in ex vivo pig lung. Eur J Cardiothorac Surg, 2011, 40(1): e34-e38.
16.	赵玉沛, 胡亚, 廖泉, 等. 直线切割闭合器在胰体尾切除术中的作用. 中华外科杂志, 2008, 46(1): 24-26.
17.	Okano K, Kakinoki K, Suto H, et al. Slow parenchymal flattening technique for distal pancreatectomy using an endopath stapler: simple and safe technical management. Hepatogastroenterology, 2010, 57(102-103): 1309-1313.
18.	Ferrone CR, Warshaw AL, Rattner DW, et al. Pancreatic fistula rates after 462 distal pancreatectomies: staplers do not decrease fistula rates. J Gastrointest Surg, 2008, 12(10): 1691-1697.
19.	刘彦国, 王俊, 李运, 等. 内镜用直线切割缝合器在全胸腔镜肺叶切除术中的应用. 中国胸心血管外科临床杂志, 2008, 15(5): 321-324.
20.	Zhou W, Lv R, Wang X, et al. Stapler vs suture closure of pancreatic remnant after distal pancreatectomy: a meta-analysis. Am J Surg, 2010, 200(4): 529-536.

1. Piastra M, Briganti V, Luca E, et al. Recurrent tracheoesophageal fistula and respiratory failure: the role of early airway endoscopic approach. Eur J Pediatr Surg, 2013, 23(2): 153-156.
2. Mohsin M, Saleem Mir I, Hanief Beg M, et al. Nasogastric tube knotting with tracheoesophageal fistula - a rare association. Interact Cardiovasc Thorac Surg, 2007, 6(4): 508-510.
3. Qadeer MA, Dumot JA, Vargo JJ, et al. Endoscopic clips for closing esophageal perforations: case report and pooled analysis. Gastrointest Endosc, 2007, 66(3): 605-611.
4. Parlak E, Dişibeyaz S, Köksal AS, et al. A new approach to gastrointestinal fistula closure: endoloop and clips technique using double endoscope. Eur J Gastroenterol Hepatol, 2012, 24(4): 464-467.
5. Tran C, Fink DS, Kunduk M, et al. Minimally invasive management of tracheoesophageal fistula with T-tube. Laryngoscope, 2015, 125(8): 1911-1914.
6. Chen YH, Li SH, Chiu YC, et al. Comparative study of esophageal stent and feeding gastrostomy/jejunostomy for tracheoesophageal fistula caused by esophageal squamous cell carcinoma. PLoS One, 2012, 7(8): e42766.
7. Rakoczy G, Brown B, Barman D, et al. KTP laser: an important tool in refractory recurrent tracheo-esophageal fistula in children. Int J Pediatr Otorhinolaryngol, 2010, 74(3): 326-327.
8. Sung MW, Chang H, Hah JH, et al. Endoscopic management of recurrent tracheoesophageal fistula with trichloroacetic acid chemocauterization: a preliminary report. J Pediatr Surg, 2008, 43(11): 2124-2127.
9. Briganti V, Coletta R, Giannino G, et al. Usefulness of dextranomer/hyaluronic acid copolymer in bronchoscopic treatment of recurrent tracheoesophageal fistula in children. Int J Pediatr Otorhinolaryngol, 2011, 75(9): 1191-1194.
10. Czymek R, Keller R, Hildebrand P, et al. Does the third staple line of a new endostapler offer an advantage?. Zentralbl Chir, 2009, 134(3): 254-259.
11. Ban D, Shimada K, Konishi M, et al. Stapler and nonstapler closure of the pancreatic remnant after distal pancreatectomy: multicenter retrospective analysis of 388 patients. World J Surg, 2012, 36(8): 1866-1873.
12. Lustosa SA, Matos D, Atallah AN, et al.Stapled versus hand-sewn methods for colorectal anastomosis surgery: a systematic review of randomized controlled trials.Sao Paulo Med J, 2002, 120( 5): 132-136.
13. Smart CJ, Jones L. Use of Echelon 60 ENDOPATH stapling device in open ileal pouch anal anastomosis (IPAA) surgery. Colorectal Dis, 2009, 11(9): 989.
14. Diener MK, Seiler CM, Rossion I, et al. Efficacy of stapler versus hand-sewn closure after distal pancreatectomy (DISPACT): a randomised, controlled multicentre trial. Lancet, 2011, 377(9776): 1514-1522.
15. Asakura K, Izumi Y, Kohno M, et al. Effect of cutting technique at the intersegmental plane during segmentectomy on expansion of the preserved segment: comparison between staplers and scissors in ex vivo pig lung. Eur J Cardiothorac Surg, 2011, 40(1): e34-e38.
16. 赵玉沛, 胡亚, 廖泉, 等. 直线切割闭合器在胰体尾切除术中的作用. 中华外科杂志, 2008, 46(1): 24-26.
17. Okano K, Kakinoki K, Suto H, et al. Slow parenchymal flattening technique for distal pancreatectomy using an endopath stapler: simple and safe technical management. Hepatogastroenterology, 2010, 57(102-103): 1309-1313.
18. Ferrone CR, Warshaw AL, Rattner DW, et al. Pancreatic fistula rates after 462 distal pancreatectomies: staplers do not decrease fistula rates. J Gastrointest Surg, 2008, 12(10): 1691-1697.
19. 刘彦国, 王俊, 李运, 等. 内镜用直线切割缝合器在全胸腔镜肺叶切除术中的应用. 中国胸心血管外科临床杂志, 2008, 15(5): 321-324.
20. Zhou W, Lv R, Wang X, et al. Stapler vs suture closure of pancreatic remnant after distal pancreatectomy: a meta-analysis. Am J Surg, 2010, 200(4): 529-536.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical efficacy of stapler technique for repair of cervical tracheoesophageal fistula

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