Abstract
Background Thoracogastric airway fistula (TGAF) is a fatal complication after esophagectomy.
Without active treatment, patients may die of intractable pneumonia, sepsis, massive
hemoptysis, or respiratory failure. We determined the clinical value of the two-tube
method that involves the precise interventional placement of the nasojejunal tube
(NJT) and nasogastric tube (NGT) for TGAF.
Methods Clinical data of patients with TGAF who had undergone fluoroscopic interventional
placement of NJT and NGT were analyzed retrospectively. The paired t-test was used to compare the index values before and after treatment. Statistical
significance was set at p < 0.05.
Results In total, 212 patients (177 male and 35 female; mean age, 61.3 ± 7.9 years [47–73])
with TGAF who had undergone the two-tube method were included. Posttreatment chest
spiral computed tomography and inflammatory indicators showed significantly improved
pulmonary inflammation compared with that before treatment. The patients' general
condition remained stable. Of 212 patients, 12 (5.7%) underwent surgical repair, 108
(50.9%) received placement of airway stents, and 92 (43.4%) cases only continued treatment
with the two-tube method owing to patients' conditions. In total, 47.8% (44/92) patients
died of secondary pulmonary infection, bleeding, and primary tumor progression, whereas
52.2% (48/92) patients survived with both tubes.
Conclusion The two-tube method, which involves the precise interventional placement of the NJT
and NGT, is simple, safe, and effective for treating TGAF. This method is a bridge
for successive treatments or a treatment itself for patients who are unsuitable for
surgical repair or stent placement.
Keywords
airway (includes related subject matter) - esophageal surgery - infection - surgery
- complications
