Esophagopleural fistula following pulmonary resection

The development of esophagopleural fistula following pulmonary resection is an uncommon but serious complication. The fistula may appear either soon after operation, due to direct trauma to the esophagus or to its blood supply during extensive dissection, or later, in association with the development of a bronchopleural fistula and empyema following the pulmonary resection. Treatment of these fistulas is usually complicated, and the recovery period is prolonged. Control of infection, hyperalimentation, obliteration of the empyema space, and closure of the fistula with a muscle or pleural flap are recommended methods of management. The pathogenesis, treatment, results, and prevention of this complication are discussed.