Bronchoscopic treatment of aerodigestive fistulas with ethanol.
C. Disdier*a (Dr), B. De Vegaa (Dr), M. Pérez-Mirandab (Dr)
a Hospital Clinico Universitario de Valladolid, Valladolid, SPAIN ; b Hospital Universitario Río Hortega, Valladolid, SPAIN
* cdisdier@separ.es
Introduction: Benign aerodigestive fistula (bADF) is a rare pathology in adults and potentially fatal due to serious nutritional and infectious complications.
Objective: To describe the results of a simple, cheap, repeatable, and effective bronchoscopic technique for the closure of benign tracheoesophageal fistulae.
Material and methods: Retrospective analysis of the efficacy of the use of absolute alcohol with or without the use of tissue glues in patients with bADF. Demographic data, etiology, previous treatments, bronchoscopic sessions, and of long-term bronchoscopic results were recorded.
Results: three patients with benign TEF have been treated for mediastinal tuberculosis, complications after surgery for esophageal carcinoma, and secondary to mediastinal Hodgkin lymphoma after treatment with polychemotherapy. The first patient was treated with a complete antituberculous regimen before endoscopic treatment and the other two with different types of esophageal stents without success. In all cases, percutaneous gastric or jejunal tube feeding was performed until the fistula was sealed. The three cases were treated with 2, 3, and 6 sessions of absolute alcohol injections with an interval of not less than 3 weeks before achieving definitive closure. No complications were recorded.
Conclusion: The injection of absolute alcohol is a safe, simple, and cheap treatment in the treatment of FADb. Several sessions are necessary and it requires prolonged nutritional support through percutaneous enteric tubes until definitive closure
Disclosure of funding source(s): none