%0 Journal Article
%T Endoluminal Vacuum Therapy for Definitive Management of an Esophagobronchial Fistula.
%A Kuckelman J
%A Bryan D
%A Wiener D
%J Ann Thorac Surg
%V 0
%N 0
%D Aug 2021 12
%M 34391698
%F 5.102
%R 10.1016/j.athoracsur.2021.07.032
%X <B>OBJECTIVE: </B>Endoluminal vacuum (EVAC) therapy has gained popularity as a minimally invasive option for contained esophageal leaks. EVAC therapy may be useful for esophagogastric anastomotic leak fistulizing to the airway.<BR><B>METHODS: </B>The following describes EVAC therapy of an esophagobronchial fistula with video depicting the conduct of the procedure including technical tips. Video and photo evidence of progression and ultimate resolution are included.<BR><B>RESULTS: </B>Sponge exchanges were completed every 3 to 4 days. EVAC therapy was administered via a transnasal approach. In the presented case, a total of 11 exchanges over 6 weeks were required. EVAC sponge placement was transitioned from intracavitary to endoluminal for the final four treatments. All but 4 exchanges were able to be completed at the bedside in a monitored setting with sedation.<BR><B>CONCLUSIONS: </B>Definitive EVAC therapy of an esophageal leak that has fistulized to a main airway is rare and challenging clinical problem. Definitive EVAC therapy for esophageal anastomotic leak with esophagobronchial fistula is a feasible option in select cases.