Tracheoesophageal Fistula: Bridging the Gap by Over‑the‑scope Clip Services

Abstract

Tracheoesophageal fistula (TOF) can be congenital or acquired. Acquired TOF can be caused by iatrogenic or traumatic or due to malignancy with pulmonary infection or aspiration being the presenting symptom. Management of TOF is associated with high mortality and morbidity and remains an interdisciplinary challenge. In general, depending on the size and location of the tracheal aspect of the fistula, surgical therapy involves primary repair of the fistula and, if necessary, resection and reconstruction of the trachea. We present two cases of iatrogenic TOF following surgery successfully closed using over‑the‑scope clips. This report also compares both the Ovesco and Padlock clip devices.

KEYWORDS

Endoscopic closure devices - over‑the‑scope clips - tracheoesophageal fistula

• REFERENCES

• 1 Ng J, Antao B, Bartram J, Raghavan A, Shawis R. Diagnostic difficulties in the management of H-type tracheoesophageal fistula. Acta Radiol 2006; 47: 801-5
• 2 Reed MF, Mathisen DJ. Tracheoesophageal fistula. Chest Surg Clin N Am 2003; 13: 271-89
• 3 Couraud L, Ballester MJ, Delaisement C. Acquired tracheoesophageal fistula and its management. Semin Thorac Cardiovasc Surg 1996; 8: 392-9
• 4 Bibas BJ, Guerreiro Cardoso PF, Minamoto H, Eloy-Pereira LP, Tamagno MF, Terra RM. et al. Surgical management of benign acquired tracheoesophageal fistulas: A Ten-year experience. Ann Thorac Surg 2016; 102: 1081-7
• 5 Shen KR, Allen MS, Cassivi SD, Nichols 3rd FC, Wigle DA, Harmsen WS. et al. Surgical management of acquired nonmalignant tracheoesophageal and bronchoesophageal fistulae. Ann Thorac Surg 2010; 90: 914-8
• 6 Linnane BM, Canny G. Congenital broncho-esophageal fistula: A case report. Respir Med 2006; 100: 1855-7
• 7 Braimbridge Mv, Keith HI. OESOPHAGO-BRONCHIAL FISTULA IN THE ADULT. Thorax 1965; 20: 226-33
• 8 Prosst RL, Kratt T. A randomized comparative trial of OTSC and padlock for upper GI hemostasis in a standardized experimental setting. Minim Invasive Ther Allied Technol 2017; 26: 65-70
• 9 Winder JS, Pauli EM. Comprehensive management of full-thickness luminal defects: The next frontier of gastrointestinal endoscopy. World J Gastrointest Endosc 2015; 7: 758-68