{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:57:21Z","timestamp":1793145441276,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,1,15]],"date-time":"2015-01-15T00:00:00Z","timestamp":1421280000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,1,15]],"date-time":"2015-01-15T00:00:00Z","timestamp":1421280000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tracheobronchial (TB) injury and fistula formation during the perioperative period of esophagectomy is a rare but life\u2010threatening complication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We examined the development of intraoperative TB injury and postoperative TB fistulas in consecutive 763 patients with esophageal cancer who underwent esophagectomy, including 494 patients who underwent transthoracic subtotal esophagectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>TB injury and fistulas developed in two (0.4 %) and four patients (0.8 %), respectively, who received transthoracic esophagectomy. TB injury developed during the dissection of a tumor invading a major airway. Direct suturing of the laceration and covering it using a muscle flap was effective for one patient, while additional repair with a major pectoral muscle flap was needed in another patient. Postoperative TB fistulas developed due to peri\u2010tracheal infection in two patients, and conservative treatment with drainage was performed. In another two patients, gastro\u2010tracheal fistulas developed due to mechanical compression of staplers on the gastric tube, which was elevated via the posterior mediastinal route. The direct repair of the gastric tube and covering it with a major pectoral muscle flap resulted in the resolution of these fistulas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Careful dissection with direct vision of the esophagus, as well as oversewing of the staplers on the gastric tube, is mandatory for preventing TB injury and fistula formation. Appropriate drainage is effective in cases with peri\u2010tracheal abscesses. If the TB fistula fails to heal within a 4\u2010 to 6\u2010week period, conservative management should be abandoned. Direct surgical intervention with coverage by a muscle flap is important for TB fistulas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-015-2945-4","type":"journal-article","created":{"date-parts":[[2015,1,14]],"date-time":"2015-01-14T10:10:58Z","timestamp":1421230258000},"page":"1119-1126","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Tracheobronchial Fistula During the Perioperative Period of Esophagectomy for Esophageal Cancer"],"prefix":"10.1002","volume":"39","author":[{"given":"Masaru","family":"Morita","sequence":"first","affiliation":[{"name":"Department of Surgery and Science, Graduate School of Medical Sciences Kyushu University 3\u20101\u20101 Maidashi, Higashi\u2010ku 812\u20108582 Fukuoka Japan"},{"name":"Department of Gastroenterological Surgery National Kyushu Cancer Center 3\u20101\u20101 Notame, Minami\u2010ku 811\u20101395 Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Saeki","sequence":"additional","affiliation":[{"name":"Department of Surgery and Science, Graduate School of Medical Sciences Kyushu University 3\u20101\u20101 Maidashi, Higashi\u2010ku 812\u20108582 Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuro","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Surgery and Science, Graduate School of Medical Sciences Kyushu University 3\u20101\u20101 Maidashi, Higashi\u2010ku 812\u20108582 Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiji","family":"Oki","sequence":"additional","affiliation":[{"name":"Department of Surgery and Science, Graduate School of Medical Sciences Kyushu University 3\u20101\u20101 Maidashi, Higashi\u2010ku 812\u20108582 Fukuoka 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