Drainage tube placement via transnasal route for the treatment of mediastinal anastomotic fistula after surgery of esophageal cancer: clinical analysis of 6 cases / 介入放射学杂志

ABSTRACT

Objective To evaluate the clinical feasibility of performing the placement of drainage tube via transnasal route in treating mediastinal anastomotic fistula after surgery of esophageal cancer.Methods A total of 6 patients with mediastinal anastomotic fistula after surgery of esophageal cancer,who were admitted to authors' hospital during the period from August 2015 to January 2016,were included in this study.The diagnosis was confirmed by esophageal radiography and thoracic CT scan in all the 6 patients.Under X-ray monitoring,the drainage tube was inserted into the cavity of mediastinal fistula with the help of a guide wire guidance,and continuous negative pressure suction was adopted.The jejunum nutrition tube was inserted via the same nostril if feeding tube was not placed.Results Successful placement of fistula drainage tube and jejunum nutrition tube was achieved in all the 6 patients.In one patient the fistula drainage tube had to be re-placed as the drainage tube was obstructed five days after initial placement.Under X-ray monitoring the mean time used for the drainage tube placement was 33 min (range of 23-48 min).The procedure was well tolerated by all the 6 patients,and no procedure-related complications occurred.After continuous negative pressure suction that lasted for 6-40 days (mean of 23 days) the fistulae healed.Conclusion For the treatment of mediastinal anastomotic fistula after surgery of esophageal cancer,the placement of fistula drainage tube under X-ray monitoring is simple,safe and effective.(J Intervent Radiol,2017,26250-252)