Thoracostomach–Airway (Trachea/Bronchus) Fistula

Abstract

For many years, earlier stages of esophageal cancer and cardiac cancers have been treated using extensive reconstruction. Reconstruction of the upper alimentary tract through the stomach is one of the most important procedures after reconstruction of the esophagus. In 1933, Ohsawa conducted surgery in which the stomach was used for the reconstruction of the resected esophagus. The stomach has become the favoured organ to use for reconstruction after extensive resection of the esophagus because it makes the operation much easier and results in lower mortality and complication rates. At present, in surgeries that involve the esophagus, extensive resection of the esophagus is widely accepted together with esophagogastrostomy above the aortic arch or at the neck. It is performed by pulling up the stomach to the post mediastinum in which the esophagus is located (Fig. 11.1). However, the blood supply and innervation of the thoracostomach are significantly changed after this surgery, and, in addition, tumor residue, recurrence, and injury caused by postoperative cancer can result in various thoracostomach complications.