naa a22 4500 510728278 CHVBK 20180411082943.0 cr unu---uuuuu 180411e20131001xx s 000 0 eng 10.1007/s11748-013-0280-y doi (NATIONALLICENCE)springer-10.1007/s11748-013-0280-y Surgical strategy for aortoesophageal fistula in the endovascular era [Elektronische Daten] [Suguru Kubota, Norihiko Shiiya, Yasushige Shingu, Satoru Wakasa, Tomonori Ooka, Tsuyoshi Tachibana, Hidetoshi Yamauchi, Yoshimitu Ishibashi, Jun-ichi Oba, Yoshiro Matsui] Objective: Aortoesophageal fistula (AEF) is relatively rare and usually life-threatening. Lots of strategies have so far been discussed for this entity including the role of endovascular repair. The aim of this study is to review our experiences and reconsider the surgical strategy for aortoesophageal fistula in the endovascular era. Methods: This is a retrospective multicenter study. From 1995 to 2011, 10 aortoesophageal fistula cases were identified in four institutions. For all of these cases surgical procedures and results were retrieved from medical records. Results: Six patients underwent open aortic repair and four patients underwent thoracic endovascular aortic repair (TEVAR) as a primary intervention. Three patients who underwent open aortic repair with esophagectomy and omental coverage in early phase, either as a primary intervention or performed after bridging TEVAR, showed 100% 1-year survival. On the other hand, three patients with TEVAR alone did not survive more than 1year without recurrence. One patient with bridging TEVAR underwent concomitant esophageal resection and conventional aortic graft replacement 2days later, and simultaneous gastric tube reconstruction was performed with intact whole omentum covering the aortic prosthesis. This patient is doing well with no sign of infection at 1-year follow-up. Conclusion: For AEF, TEVAR as a primary approach is quite useful to stabilize the patients' condition. However, definitive aortic repair with omental coverage should be performed as early as possible as a next step. It may be one of the strategies for the treatment of AEF that concomitant esophageal resection and aortic graft replacement is performed with simultaneous gastric tube reconstruction with intact whole omentum after removing the stent graft, so far as the patient's physical condition permits. The Japanese Association for Thoracic Surgery, 2013 Aortoesophageal fistula nationallicence Endovascular aortic repair nationallicence Esophagectomy nationallicence Omental coverage nationallicence Kubota Suguru Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan aut Shiiya Norihiko Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan aut Shingu Yasushige Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan aut Wakasa Satoru Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan aut Ooka Tomonori Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan aut Tachibana Tsuyoshi Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan aut Yamauchi Hidetoshi Division of Cardiovascular Surgery, Obihiro-Kosei General Hospital, Obihiro, Japan aut Ishibashi Yoshimitu Department of Cardiovascular Surgery, Hokkaido Cancer Center, Sapporo, Japan aut Oba Jun-ichi Department of Cardiovascular and Thoracic Surgery, Asahikawa City Hospital, Asahikawa, Japan aut Matsui Yoshiro Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan aut General Thoracic and Cardiovascular Surgery Springer Japan 61/10(2013-10-01), 560-564 1863-6705 61:10<560 2013 61 11748 https://doi.org/10.1007/s11748-013-0280-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11748-013-0280-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kubota Suguru Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan aut NATIONALLICENCE 700 1- Shiiya Norihiko Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan aut NATIONALLICENCE 700 1- Shingu Yasushige Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan aut NATIONALLICENCE 700 1- Wakasa Satoru Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan aut NATIONALLICENCE 700 1- Ooka Tomonori Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan aut NATIONALLICENCE 700 1- Tachibana Tsuyoshi Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan aut NATIONALLICENCE 700 1- Yamauchi Hidetoshi Division of Cardiovascular Surgery, Obihiro-Kosei General Hospital, Obihiro, Japan aut NATIONALLICENCE 700 1- Ishibashi Yoshimitu Department of Cardiovascular Surgery, Hokkaido Cancer Center, Sapporo, Japan aut NATIONALLICENCE 700 1- Oba Jun-ichi Department of Cardiovascular and Thoracic Surgery, Asahikawa City Hospital, Asahikawa, Japan aut NATIONALLICENCE 700 1- Matsui Yoshiro Department of Cardiovascular and Thoracic Surgery, Hokkaido University Hospital, Kita-14, Nishi-5, Kita-ku, 060-8648, Sapporo, Japan aut NATIONALLICENCE 773 0- General Thoracic and Cardiovascular Surgery Springer Japan 61/10(2013-10-01), 560-564 1863-6705 61:10<560 2013 61 11748 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer