Surgery is the primary treatment for esophageal cancer, but the postoperative complication rate remains high. Therefore, it is important to prevent and manage postoperative complications to improve prognosis. Common perioperative complications of esophageal cancer include anastomotic leakage, gastrointestinal tracheal fistula, chylothorax, and recurrent laryngeal nerve injury. Respiratory and circulatory system complications, such as pulmonary infection, are also quite common. These surgery-related complications are independent risk factors for cardiopulmonary complications. Complications, such as long-term anastomotic stenosis, gastroesophageal reflux, and malnutrition are also common after esophageal cancer surgery. By effectively reducing postoperative complications, the morbidity and mortality of patients can be reduced, and their quality of life can be improved.
Humans ; Quality of Life ; Postoperative Complications/prevention & control* ; Anastomotic Leak/etiology* ; Esophageal Neoplasms/surgery* ; Prognosis ; Esophagectomy/adverse effects* ; Digestive System Fistula/surgery* ; Retrospective Studies

Atrial Fibrillation/surgery* ; Catheter Ablation ; Esophageal Fistula/surgery* ; Heart Atria ; Humans

OBJECTIVE: To summarize the experience in the application of muscle relaxants in the perioperative period in neonates with congenital esophageal atresia-tracheoesophageal fistula (EA-TEF). METHODS: A retrospective analysis was performed on the medical data of 58 previously untreated neonates with EA-TEF who were treated in the Neonatal Center of Beijing Children's Hospital, Capital Medical University from 2017 to 2019. The incidence rate of anastomotic leak was compared between the neonates receiving muscle relaxants for different durations after surgery (≤ 5 days and > 5 days). The correlation between the duration of postoperative use of muscle relaxants and the duration of mechanical ventilation was evaluated. RESULTS: Among the 58 neonates with EA-TEF, 44 underwent surgery, among whom 35 with type III EA-TEF underwent thoracoscopic surgery. Among these 35 neonates, 30 (86%) received muscle relaxants after surgery, with a median duration of 4.75 days, and 6 (18%) experienced anastomotic leak. There was no significant difference in the incidence rate of anastomosis leak between the ≤ 5 days and > 5 days groups ( CONCLUSIONS Prolonged use of muscle relaxants after surgery cannot significantly reduce the incidence of anastomotic leak, but can prolong the duration of invasive mechanical ventilation in neonates with EA-TEF. Therefore, prolonged use of muscle relaxants is not recommended after surgery.
Child ; Esophageal Atresia/surgery* ; Humans ; Infant, Newborn ; Muscles ; Postoperative Complications/etiology* ; Prognosis ; Retrospective Studies ; Tracheoesophageal Fistula/surgery* ; Treatment Outcome

Duodenal Obstruction ; surgery ; Esophageal Atresia ; surgery ; Female ; Humans ; Infant, Newborn ; Male ; Tracheoesophageal Fistula ; surgery

Epiphrenic diverticula are known to cause a series of complications. We report the case of a 54-year-old woman who was diagnosed with an epiphrenic diverticulum at a regular checkup in November 2006. Ten years later, she presented with massive hematemesis. Imaging studies revealed an epiphrenic diverticulum measuring 7.8 cm in diameter and a large amount of bleeding inside the diverticulum. Computed tomography showed fistula formation between the diverticulum and the left lower lobe of the lung, leading to the development of a pulmonary abscess. Diverticulectomy and 180° posterior partial fundoplication were performed transabdominally. The pulmonary abscess was treated with antibiotics alone. She was discharged 16 days after the operation without any complications over 7 months of follow-up.
Anti-Bacterial Agents ; Diverticulum ; Diverticulum, Esophageal ; Female ; Fistula ; Follow-Up Studies ; Fundoplication ; Hematemesis ; Hemorrhage ; Humans ; Lung ; Lung Abscess ; Middle Aged

Esophageal stents are used frequently to treat a wide variety of esophageal diseases. The indications for esophageal stent placement can be divided into malignant and benign conditions. Recent data support the utilization of esophageal stents for the treatment of malignant or benign strictures. They are also being used increasingly for the sealing and treatment of esophageal leaks, fistulas, and perforations. On the other hand, stent placement is also associated with complications, such as migration, chest pain, hemorrhage, and perforation. Therefore, it is essential to know the precise indications of stent insertion. This article reviews the recent guidelines for esophageal stent insertion.
Chest Pain ; Constriction, Pathologic ; Esophageal Diseases ; Esophagus ; Fistula ; Hand ; Hemorrhage ; Stents

A rare case of esophageal atresia/tracheo-esophageal fistula (EA-TEF) with an associated tracheobronchial remnant (TBR) is reported and discussed herein. A 13-month-old patient was seen with a complaint of vomiting of solid food 1 year after EA-TEF repair. An esophagogram showed a tapered narrowing in the lower segment of the esophagus. A re-operation was carried out and a pathologic examination of the resected stenotic segment revealed the presence of a TBR.
Esophageal Atresia ; Esophageal Stenosis ; Esophagus ; Fistula ; Humans ; Infant ; Vomiting

Esophageal stents are used frequently to treat a wide variety of esophageal diseases. The indications for esophageal stent placement can be divided into malignant and benign conditions. Recent data support the utilization of esophageal stents for the treatment of malignant or benign strictures. They are also being used increasingly for the sealing and treatment of esophageal leaks, fistulas, and perforations. On the other hand, stent placement is also associated with complications, such as migration, chest pain, hemorrhage, and perforation. Therefore, it is essential to know the precise indications of stent insertion. This article reviews the recent guidelines for esophageal stent insertion.
Chest Pain ; Constriction, Pathologic ; Esophageal Diseases ; Esophagus ; Fistula ; Hand ; Hemorrhage ; Stents

Infective endocarditis (IE) is not a common cause of stroke. Considering the high mortality rates, however, IE should always be considered as a possible cause of stroke even when the chances are low. Atrioesophageal fistula is a life-threatening condition that can cause IE and subsequent stroke, but the diagnosis is often delayed due to its rarity. We report a case of multiple embolic infarcts caused by infective endocarditis associated with atrioesophageal fistula after radiofrequency catheter ablation for atrial fibrillation.
Atrial Fibrillation ; Catheter Ablation ; Diagnosis ; Endocarditis ; Esophageal Fistula ; Fistula ; Mortality ; Stroke

Esophageal atresia (EA) with proximal tracheoesophageal fistula (TEF; gross type B) is a rare defect. Although most patients have long-gap EA, there are still no established surgical guidelines. A premature male infant with symmetric intrauterine growth retardation (birth weight, 1,616 g) was born at 35 weeks and 5 days of gestation. The initial diagnosis was pure EA (gross type A) based on failure to pass an orogastric tube and the absence of stomach gas. A “feed and grow” approach was implemented, with gastrostomy performed on postnatal day 2. A fistula was detected during bronchoscopy for recurrent pneumonia; thus, we confirmed type B EA and performed TEF excision and cervical end esophagostomy. As the infant's stomach volume was insufficient for bolus feeding after reaching a body weight of 2.5 kg, continuous tube feeding was provided through a gastrojejunal tube. On the basis of these findings, esophageal reconstruction with gastric pull-up was performed on postnatal day 141 (infant weight, 4.7 kg), and he was discharged 21 days postoperatively. At 12 months after birth, there was no catch-up growth; however, he is currently receiving a baby food diet without any complications. In patients with EA, bronchoscopy is useful for confirming TEF, whereas for those with long-gap EA with a small stomach volume, esophageal reconstruction with gastric pull-up after continuous feeding through a gastrojejunal tube is worth considering.
Body Weight ; Bronchoscopy ; Diagnosis ; Diet ; Enteral Nutrition ; Esophageal Atresia* ; Esophagostomy ; Fetal Growth Retardation ; Fistula ; Gastrostomy ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Male ; Parturition ; Pneumonia ; Pregnancy ; Stomach ; Tracheoesophageal Fistula