CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(05): E591-E595
DOI: 10.1055/a-1119-6352
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Endoscopic closure of refractory esophageal fistula after esophagectomy using polyglycolic acid sheets: a pilot study

Yasuaki Nagami
1  Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Masaki Ominami
1  Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Taishi Sakai
1  Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
2  Department of Gastroenterology, Baba Memorial Hospital 4-244, Nishiku Hamadera Funao-Town-Higashi, Sakai-City, Japan
,
Shusei Fukunaga
1  Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Fumio Tanaka
1  Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Koichi Taira
1  Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Tetsuya Tanigawa
1  Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Shigeru Lee
3  Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Toshio Watanabe
1  Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
,
Yasuhiro Fujiwara
1  Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
› Author Affiliations
  

Abstract

Background and study aims Esophageal fistulas after esophagectomy are associated with high mortality and poor quality of life. They are sometimes intractable to conservative management and surgery that increases mortality. Few studies have assessed use of polyglycolic acid (PGA) sheets with fibrin glue for esophageal fistulas. We investigated the safety of using PGA sheets with fibrin glue for esophageal fistulas after esophagectomy.

Patients and methods This was a single-center prospective pilot study. Patients who had refractory esophageal fistulas after esophagectomy were included. PGA sheets were filled in the fistula using biopsy forceps. Fibrin glue was applied to the PGA sheets. We repeated the procedure 1 week later. The outcome measures were the incidence of adverse events (AEs) and closure of the fistula.

Results Five patients were assessed. No adverse events were observed. The esophageal fistula was closed with the application of PGA sheets four times in 40 % (2/5) of the cases.

Conclusions PGA sheets with fibrin glue were safe for esophageal fistula closure after esophagectomy and do not involve the risk of AEs.



Publication History

Received: 30 July 2019

Accepted: 23 January 2019

Publication Date:
17 April 2020 (online)

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