Gastric tube-bronchial fistula after esophagectomy for cancerr

Gastric tube-bronchial fistula is an unusual complication after esophagectomy for cancer. Between and, We encountered five cases of gastric tube-bronchial fistula. The mean age of subjects, consisting of 4 men and 1 woman, was 60.4 years. All subjects received subtotal esophagectomy for esophageal cancer with reconstruction of the gastric tube through the posterior mediastinal route. The causes were gastric tube necrosis in 3 cases, anastomotic leak in 1 case and gastric tube ulcer in 1 case. Symptoms occurred between 16 to 630 days after the initial operation. The sites of fistulas in the tracheal side were high trachea for the anastomotic leak case, low trachea for gastric tube necrosis cases, and right bronchus for the gastric tube ulcer case. Therefore, the causes varied for the different sites of fistulas in the trachea. Operations were performed in 4 cases while conservative management was possible in 1 case. We needed resection of the gastric tube and closure of the fistula with transposition of a pedicled muscle flap. However, it was possible for limited cases such as small fistula to be managed conservatively. Gastric tube-bronchial fistula is a fatal complication, and therefore diagnosis and rapid treatment are essential.