PDF icon Download PDF
Thorac Cardiovasc Surg 2024; 72(02): 156-161
DOI: 10.1055/a-2122-7149
Original Thoracic

The Two-Tube Method for Treating Thoracogastric Airway Fistula

Chenchen Zhang
1   Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Henan, China
,
Xiaobing Li
1   Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Henan, China
,
Zhanfeng He
2   Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Henan, China
,
Shuai Wang
1   Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Henan, China
,
Meipan Yin
1   Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Henan, China
,
Yaozhen Ma
1   Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Henan, China
,
Gang Wu
1   Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Henan, China
› Author Affiliations
› Further Information
   Permissions and Reprints All articles of this category
Preview

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


Publication History

Received: 14 March 2023

Accepted: 29 June 2023

Accepted Manuscript online:
04 July 2023

Article published online:
03 August 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany