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Case Reports in Surgery
Volume 2015, Article ID 728393, 3 pages
http://dx.doi.org/10.1155/2015/728393
Case Report

Gastrotracheal Fistula as a Result of Transhiatal Esophagectomy for Esophageal Cancer: An Unusual Complication

1Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
2Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
3Department of Thoracic Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
4Department of Anesthesiology, Shiraz University of Medical Sciences, Shiraz, Iran
5Shiraz University of Medical Sciences, Shiraz, Iran
6Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Received 20 June 2015; Accepted 20 September 2015

Academic Editor: Kevin Reavis

Copyright © 2015 Heshmatollah Salahi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Gastrotracheal fistula following open transhiatal esophagectomy (Orringer’s technique) for esophageal cancer is an unusual but lethal complication. Surgical intervention with resection of the fistula tract and primary interrupted suturing of gastric and tracheal orifices using a muscle flap interposition has proved to be a successful method. We report the case of a 73-year-old male with an adenocarcinoma of the distal part of the esophagus, who underwent open transhiatal esophagectomy (Orringer’s technique) with gastric tube reconstruction and cervical anastomosis. The patient did not receive induction chemoradiotherapy before the esophagectomy. Two attempts of surgical repair of fistula failed and the patient died. Being aware of warning signs such as dyspnea and respiratory distress accompanied by bilious content in the tracheal tube is helpful in the early detection and treatment of this type of fistula.