Bronchoesophageal Fistula After Systematic Mediastinal Lymph Node Dissection With Pulmonary Lobectomy

We present a case of a bronchoesophageal fistula after a lobectomy with systematic mediastinal lymphadenectomy for lung adenocarcinoma. A 70-year-old woman was readmitted with postprandial cough, fever, and dysphagia on postoperative day 13. Computed tomography revealed a bronchoesophageal fistula between the left main bronchus and esophagus. Esophagogastroscopy revealed a 3-mm fistula 30 cm from the incisors. Two rounds of endoscopic closure with metal clips were performed. The patient has survived for 24 months with no evidence of recurrent fistula. Although postoperative ischemic bronchitis after mediastinal lymphadenectomy may cause bronchoesophageal fistulas, they can be treated with endoscopic closure.