Year 2023 / Volume 115 / Number 1
Letter
Endoscopic management of postoperative fistulas using purse-string suture combined with cyanoacrylate

54-55

DOI: 10.17235/reed.2022.9017/2022

Ding-guo Zhang, Li-juan Ye, Li-sheng Wang, De-feng Li,

Abstract
A 65-year-old man complained of choking and hoarseness for fifteen days, and was diagnosed with thyroid carcinoma infiltrating esophagus and trachea. Therefore, the patient underwent thyroidectomy, partial esophagectomy, and partial tracheal resection, and histopathology confirmed primary squamous cell carcinoma of the thyroid. Unfortunately, on the tenth postoperative day, an esophagogastroduodenoscopy showed a large fistula (25 mm*20 mm) in esophageal introitus, and diagnosed with tracheoesophageal fistula due to sustained choking. The patient failed to response to conservative treatment within 14 days. Consequently, endoscopic management was performed that the fistula was partly closed by purse-string suture using endoloop and hemostatic clips, then 1 ml of cyanoacrylate (Compon, China) was injected into the fistulous tract through a catheter. Interestingly, the patient’s symptom was relieved after the procedure. And, esophagogastroduodenoscopy revealed healing of the fistula 14 days later.
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References
1. Bemelman WA, Baron TH. Endoscopic Management of Transmural Defects, Including Leaks, Perforations, and Fistulae. Gastroenterology 2018;154:1938-1946 e1.
2. Li DF, Zhu SZ, Xu ZL, et al. Unusual case of a large small-bowel enteroenteric fistula successfully closed using purse-string sutures. Endoscopy 2020.
3. Rabago LR, Ventosa N, Castro JL, et al. Endoscopic treatment of postoperative fistulas resistant to conservative management using biological fibrin glue. Endoscopy 2002;34:632-8.
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Zhang D, Ye L, Wang L, Li D. Endoscopic management of postoperative fistulas using purse-string suture combined with cyanoacrylate. 9017/2022


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Publication history

Received: 19/06/2022

Accepted: 21/06/2022

Online First: 24/06/2022

Published: 12/01/2023

Article Online First time: 5 days

Article editing time: 207 days


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