Surgical management of acquired tracheo/bronchoesophageal fistula associated with esophageal diverticulum

The reports on acquired tracheoesophageal fistulas (TEFs) or bronchoesophageal fistulas (BEFs) associated with traction esophageal diverticula (TED) are rare. Here, we present our experience of six cases. Between Jan. 2015 and Jun. 2016, 6 patients were admitted to our department for TEF/BEFs combined with esophageal diverticula. Clinical data of the 6 patients were retrospectively reviewed. All orifices of TEF/BEF in the esophagus side opened at the diverticula wall. The orifices in the airway side were 2 at the carina and 4 at the right intermediate bronchus. All six patients received the same intervention: a limited diverticulectomy with the fistula resection was done in the esophagus; separate layers of repair were performed for the defect in the esophagus; the muscle flap interposition was used in all six cases. All postoperative courses were uneventful. No recurrence fistula and symptomatic diverticula occurred. The airway and esophagus were patency during a median of 9-month follow-up. Acquired TEF/BEFs caused by esophageal diverticula can be treated successfully by surgery. A limited diverticulectomy is sufficient to ensure enough esophagus remodeling. Tracheo/bronchoesophageal fistula (TEF/BEF); esophagus diverticulum; acquired.