Endoluminal Wound Vacuum Therapy: A Paradigm Shift in Managing Esophageal Bronchial Fistula

Abstract

Esophageal bronchial fistula after Ivor Lewis esophagectomy is a challenging complication. Surgical treatment is definitive, but it carries high morbidity and mortality, whereas esophageal stents have been shown to be temporary measures. We highlight the case of a patient who was treated with endoluminal wound vacuum therapy. The fistula healed after 9 days of therapy. The likely reason for success was the presence of an omentum between the esophagus and the bronchus that was placed during esophagectomy and that provided adequate tissue to close the fistula. In a patient with appropriate anatomy, esophageal bronchial fissure can be successfully treated with endoluminal wound vacuum therapy.