J Gastric Cancer.  2020 Dec;20(4):454-460. 10.5230/jgc.2020.20.e38.

Successful Management of a Tracheogastric Conduit Fistula after a Threefield Esophagectomy with Combined Sternocleidomastoid Muscle Rotation Flap and Histoacryl Injection Treatment

  • 1Department of Surgery, College of Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea


Tracheo-gastric conduit fistula is an extremely rare but severe complication that is difficult to manage. Conservative care, esophageal or tracheal stent placement, or cutaneomuscular flaps have been suggested; however, no definite treatment has been proven. We report a case of tracheo-gastric conduit fistula that occurred after a minimally invasive radical three-field esophagectomy. Following the primary surgery, the diagnosis was made while evaluating the patient's frequent aspiration and coughing. Conservative management failed, and a surgical correction was undertaken to identify the multifocal mucosal defect and exposed tracheal ring. A sternocleidomastoid muscle rotation flap and subsequent Histoacryl injection into the remaining fistula were performed, and the fistula was successfully managed.


Esophageal cancer; Complication; Fistula
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