Repair of a Complex Bronchogastric Fistula After Esophagectomy With Biologic Mesh

Bronchogastric conduit fistula is a rare and potentially fatal complication after esophagectomy for esophageal cancer. We report a case of a patient transferred to our institution with a complex bronchogastric conduit fistula after a thoracoscopic three-hole esophagectomy for midesophageal squamous cell carcinoma. The defect involved the entire membranous airway of the bronchus intermedius, with a 15-cm dehiscence of the gastric conduit staple line. This was successfully reconstructed with a single-stage repair by use of an Alloderm patch reinforced with an intercostal muscle flap. At postoperative follow-up the patient is doing well and tolerating a regular diet without dysphagia. (Ann Thorac Surg 2013;95:1096-7) (C) 2013 by The Society of Thoracic Surgeons