Both conventional drainage and transnasal fistula drainage can achieve high healing rates in clinical practice

Esophageal fistula is a severe clinical condition associated with high mortality rates. Currently, there is no standardized treatment of esophageal fistula. This study aimed to investigate the therapeutic outcomes between the conventional treatment group and the transnasal fistula drainage group while analyzing relevant factors influencing fistula healing.

This single-center retrospective study analyzed patients who were diagnosed with benign esophageal fistula and treated at Nanchong Central Hospital between September 2019 and November 2024. Treatment allocation was primarily based on fistula size: patients with small fistulas received conventional therapy (conventional treatment group), whereas those with large fistulas received conventional therapy combined with endoscopic transnasal fistula drainage (transnasal fistula drainage group).

The conventional treatment group achieved a healing rate of 88.6%, whereas the transnasal fistula drainage group showed a healing rate of 85.0%, demonstrating comparable ultimate healing rates between the 2 approaches. Multivariate analysis identified fistula size and albumin level as 2 independent prognostic factors affecting patient recovery.

For patients with small fistulas, conventional therapy alone achieves satisfactory healing outcomes. In cases of larger fistulas, the combination of conventional treatment with endoscopic transnasal fistula drainage yields comparable therapeutic efficacy to that observed in small fistulas.