{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T16:40:12Z","timestamp":1736613612318,"version":"3.32.0"},"reference-count":4,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T00:00:00Z","timestamp":1736553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T00:00:00Z","timestamp":1736553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Bergen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>A broncho-esophageal fistula (BEF) is a medical and surgical disaster. Treatment of BEF is often limited to palliative stent treatment that may migrate or cause erosions and tissue necrosis. Surgical repair of BEF is the only established definite treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>BEF presented in a 40-year-old female patient 8\u00a0years after curative treatment with pneumonectomy and radio-chemotherapy for advanced lung cancer. She had autoimmune comorbidity, a single lung, vocal cord paralysis and an extremely hostile thorax. Multi-disciplinary collaboration, close patient involvement and evaluation by the hospital medical ethics committee were key elements in the following treatment course. After temporary stent treatment, a carefully staged surgical marathon was performed: Veno-venous ECMO was established to secure oxygenation, and bilateral thoracotomy and laparotomy performed to access structures in the frozen mediastinum. After extensive thoracoplasty and high-risk dissection, esophagectomy was performed and the 20\u2009\u00d7\u200935\u00a0mm bronchial defect repaired by bronchoplasty with a latissimus muscle flap. It was complicated by thrombotic occlusion of the upper venous system, repeated postoperative bleedings and critical illness neuropathy. The patient recovered and was discharged 150\u00a0days after surgery. Within 1\u20132\u00a0years bronchoscopy showed a smooth undiscernible bronchoplasty with a stable open left main bronchus. At 5\u00a0years the patient lives an independent life at home with her family.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Surgical treatment of BEF in an extremely complex patient may turn out successfully. It demands careful ethical considerations, comprehensive surgical strategy, multi-disciplinary teamwork, and shared decision making with the patient. The patient presented in this case report is closely followed up with good life quality after 5\u00a0years.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13019-024-03287-5","type":"journal-article","created":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T15:59:02Z","timestamp":1736611142000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multi-disciplinary treatment of broncho-esophageal fistula in a high-risk single-lung patient"],"prefix":"10.1186","volume":"20","author":[{"given":"Rune","family":"Haaverstad","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kjell","family":"Ovrebo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorentz","family":"Sandvik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e5vard","family":"Seland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gunnar Reksten","family":"Huseb\u00f8","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vegard Skalstad","family":"Ellensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marit","family":"Farstad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eivind","family":"Strandenes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajinder","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne","family":"\u00d8ksnes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anders Kjellevold","family":"Storesund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Solveig Moss","family":"Kolseth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,11]]},"reference":[{"issue":"6","key":"3287_CR1","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1007\/s12055-022-01381-8","volume":"38","author":"E Slomowitz","year":"2022","unstructured":"Slomowitz E, Tverskov V, Wiesel O. Combined pneumonectomy and esophagectomy for radiation-associated broncho-esophageal fistula. Indian J Thorac Cardiovasc Surg. 2022;38(6):648\u201350.","journal-title":"Indian J Thorac Cardiovasc Surg"},{"issue":"5","key":"3287_CR2","doi-asserted-by":"publisher","first-page":"1378","DOI":"10.1016\/j.jtcvs.2006.11.007","volume":"133","author":"S Griffo","year":"2007","unstructured":"Griffo S, Stassano P, Iannelli G, Di Tommaso L, Cicalese M, Monaco M, Ferrante G. Benign bronchoesophageal fistula: report of four cases. J Thorac Cardiovasc Surg. 2007;133(5):1378\u20139.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"3287_CR3","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.ijscr.2016.09.013","volume":"28","author":"GC Ginesu","year":"2016","unstructured":"Ginesu GC, Feo CF, Cossu ML, Ruiu F, Addis F, Fancellu A, et al. Thoracoscopic treatment of a broncho-esophageal fistula: a case report. Int J Surg Case Rep. 2016;28:74\u20137.","journal-title":"Int J Surg Case Rep"},{"issue":"8","key":"3287_CR4","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1136\/jme.2010.035535","volume":"36","author":"I Miljeteig","year":"2010","unstructured":"Miljeteig I, Johansson KA, Sayeed SA, Norheim OF. End-of-life decisions as bedside rationing. An ethical analysis of life support restrictions in an Indian neonatal unit. J Med Ethics. 2010;36(8):473\u20138.","journal-title":"J Med Ethics."}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-03287-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-024-03287-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-03287-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T16:03:11Z","timestamp":1736611391000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/s13019-024-03287-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,11]]},"references-count":4,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3287"],"URL":"https:\/\/doi.org\/10.1186\/s13019-024-03287-5","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,11]]},"assertion":[{"value":"9 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The patient has provided written informed consent for inclusion and publication of this case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"RH is the guarantor of the content of the manuscript and takes responsibility for the integrity of the information and data presented.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor statement"}}],"article-number":"61"}}