• Archives of Reconstructive Microsurgery
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• v.23 no.1
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• pp.21-24
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• 2014

Bronchopleural fistula is an unnatural communication between the bronchial tree and pleural space. Closure of the bronchial stump using various muscular flaps has been previously reported. There have been few reports on treatment of large defects with bronchopleural fistula accompanied by surrounding muscle injury. We report on our experience with two patients suffering from large defect with bronchopleural fistula, who were treated with free flaps. No recurrence of bronchopleural fistula was observed during follow-up.

• Journal of Chest Surgery
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• v.33 no.6
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• pp.525-527
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• 2000

Subarachnoid-pleural fistula after routine thoracotomy is a rare complication but a very serious problem. Twenty one cases have been reported in the literature. We report a care of subarchnoid-pleural fistula that dveloped after the esecation of posterior mediastinal neurogenic tumor. The patient presented with large amount of clear pleural fluid with mild headache and dizziness. Surgical intervention following a trial of conservative therapy was undertaken because we strongly suspected subarachnoid-pleural fistula. A dural tear was found at the level of resected intercostal nerve root. The dura was closed by way of direct suture and fibrin glue. In this case, the recognition of subarachnoid-pleural fistula formation is difficult because the patient had not presented any neurologic deficit.

• Journal of Chest Surgery
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• v.33 no.10
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• pp.839-842
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• 2000

Aortoesophageal fistula is an uncommon and fatal complication after surgery of aortic aneurysm. A case of aortoesophageal fistula as a complication of synthetis patch aortoplasty for mycotic aneurysm of descending thoracic aorta is described. After 3 months since patch aortoplasty for mycotic aneurysm of descending thoracic aorta this patient visited the emergency room due to melena and hematemesis. After gastrofiberoscopy and computed tomography the patient was taken ot the operating room. The surgical intervention was performed in two steps. Median sternotomy and midline laparotomy were made. Hemashield's Dacron(16mm) bypass between ascending thoracic aorta and infra-renal abdominal aorta was established first. Through the posterolateral thoracotomy false aneurysm and previous Hemashield's Dacron patch of descending aorta were resected. The two ends of the aorta were sutured and esophageal fistula was repaired. The esophageal suture line and the stumps were covered with omental graft. Thirty months later the patient has had no difficulty referable to the aortic surgery.

• Advances in pediatric surgery
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• v.16 no.2
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• pp.170-176
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• 2010

The clinical characteristics of fistula-in-ano in infants are different from those of older children, and its treatment remains controversial. We suggest that fistula-in-ano in infants has a congenital etiology. To verify this hypothesis and to settle the controversies regarding fistula-in ano in infants, a retrospective analysis of 29 patients less than 2 years of age with anal fistulae treated between 1994 and 2009 at Samsung Changwon Hospital were reviewed retrospectively. Twenty two patients were male and mean age at diagnosis was $7.2{\pm}5.2$ months. Eleven out of 22 cases had previous surgical drainage for perianal abscess. 18 patients had fistulotomy (81.8 %) and four had fistulectomy (18.2 %). Cryptotomies with fistulectomy were performed in 10 patients (45.5 %) who had involved crypt. There was one recurrence. These results suggest that fistula-in-ano in young children less than two years of age is different from those in older children or adults. Fistulotomy is suggested to be the recommended treatment of choice. A future study involving non-operative management would be required to explore all treatment options.

• Korean Journal of Bronchoesophagology
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• v.3 no.2
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• pp.332-337
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• 1997

Congenital bronchoesophageal fistula is rare and usually has an incidious clinical course. We experienced a case of congenital bronchoesophageal fistula in adult. A 53 years old male patient visited our hospital for respiratory arrest following sudden dyspnea. He had experienced chronic coughing after swallowing and recurrent pneumonia since childhood. we could confirm the bronchoesophageal fistula preoperatively by barium swallow examination and performed right pneumonectomy and repair of the fistula. The postoperative course was uneventful.

• Kosin Medical Journal
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• v.33 no.3
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• pp.386-390
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• 2018

Congenital bronchoesophageal fistula (BEF) is rarely reported in adults in the English literature. Herein, we present a rare case of congenital BEF in a 43-year-old man that was incidentally found on esophagogastroduodenoscopy. Chest CT and barium esophagography revealed a fistula between his lower esophagus and the right lower lobe segmental bronchus. After the fistula was surgically treated, the fistula was no longer noted on follow-up barium esophagography.

• Journal of Gastric Cancer
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• v.20 no.4
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• pp.454-460
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• 2020

Tracheo-gastric conduit fistula is an extremely rare but severe complication that is difficult to manage. Conservative care, esophageal or tracheal stent placement, or cutaneomuscular flaps have been suggested; however, no definite treatment has been proven. We report a case of tracheo-gastric conduit fistula that occurred after a minimally invasive radical three-field esophagectomy. Following the primary surgery, the diagnosis was made while evaluating the patient's frequent aspiration and coughing. Conservative management failed, and a surgical correction was undertaken to identify the multifocal mucosal defect and exposed tracheal ring. A sternocleidomastoid muscle rotation flap and subsequent Histoacryl injection into the remaining fistula were performed, and the fistula was successfully managed.

• Archives of Craniofacial Surgery
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• v.18 no.2
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• pp.141-144
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• 2017

An odontogenic cutaneous fistula is a pathological communication between the outer skin surface of the face and the oral cavity. Facial cutaneous fistula is a complication of odontogenic infection that is often misdiagnosed with skin infection. We report a rare case, which was diagnosed as basal cell carcinoma based on the biopsy of skin lesions in the patient who had been diagnosed with odontogenic cutaneous fistula. A 64-year-old male patient presented with a cutaneous odontogenic fistula. The patient had undergone surgical extraction of fistula tract and loose tooth before dermatology or plastic surgery consultation. With the biopsy and computed tomography, it was confirmed that fistula and basal cell carcinoma. However, the connection between the fistula and skin cancer was not clear. Positron emission tomography-computed tomography scan was performed and was not detected as other local or distant metastasis. After that, wide excision of the skin lesion was performed. Although skin cancer is not commonly observed, it is necessary to rule out this disease entity by performing biopsy of skin lesions.

• Archives of Plastic Surgery
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• v.44 no.6
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• pp.530-538
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• 2017

Background A pharyngocutaneous fistula is a common and difficult-to-manage complication after head and neck reconstruction. It can lead to serious complications such as flap failure, carotid artery rupture, and pharyngeal stricture, and may require additional surgery. Previous radiotherapy, a low serum albumin level, and a higher T stage have been proposed as contributing factors. We aimed to clarify the risk factors for pharyngocutaneous fistula in patients who underwent flap reconstruction and to describe our experiences in treating pharyngocutaneous fistula. Methods Squamous cell carcinoma cases that underwent flap reconstruction after cancer resection from 1995 to 2013 were analyzed retrospectively. We investigated several significant clinical risk factors. The treatment modality was selected according to the size of the fistula and the state of the surrounding tissue, with options including conservative management, direct closure, flap surgery, and pharyngostoma formation. Results A total of 127 cases (18 with fistulae) were analyzed. A higher T stage (P=0.048) and tube-type reconstruction (P=0.007) increased fistula incidence; other factors did not show statistical significance (P>0.05). Two cases were treated with conservative management, 1 case with direct closure, 4 cases with immediate reconstruction using a pectoralis major musculocutaneous flap, and 11 cases with direct closure (4 cases) or additional flap surgery (7 cases) after pharyngostoma formation. Conclusions Pharyngocutaneous fistula requires global management from prevention to treatment. In cases of advanced-stage cancer and tube-type reconstruction, a more cautious approach should be employed. Once it occurs, an accurate diagnosis of the fistula and a thorough assessment of the surrounding tissue are necessary, and aggressive treatment should be implemented in order to ensure satisfactory long-term results.

• Korean Journal of Head & Neck Oncology
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• v.30 no.2
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• pp.39-42
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• 2014

Background and Objectives : Pharyngocutaneous fistula is the most common complication after total laryngectomy. The objective of this study was to determine the incidence of pharyngocutaneous fistula after total laryngectomy in patients operated on in our department and to establish whether specific factors predispose to fistula formation. Materials and Methods : For 10 years(2003-2014), 49 cases of patients who were diagnosed with laryngeal cancer and underwent total laryngectomy in our department. Patients who underwent radiotherapy before the surgery was 24 cases(48.9%) of all total laryngectomy patients. And those who were needed flap reconstruction because of extensive tumor involvement to hypopharynx were also 24 cases(48.9%), whereas primary closure were performed in 25 cases(51%). Results : The postoperative pharyngocutaneous fistula was found in 12 of the 49 patients(24.5%). The radiotherapy before surgery was a statistically significant factor that increase the incidence of postoperative fistulas(p=0.037). Large extent of surgery including flap reconstruction was almost statistically significant factor of raising postoperative fistula rates(p=0.051). Conclusion : According to this study, the presence of postoperative fistula seems to be influenced by previous radiotherapy and the extent of surgery. These could be the risk factors of pharyngocutaneous fistula after total laryngectomy.