Gastropleural fistula (GPF) is a complex pathology that can present as a result of surgery, trauma, peptic ulcer disease, malignancies, radiation, or chemotherapy. Management typically includes endoscopic or surgical intervention along with intraabdominal or intrathoracic drainage of pre-existing infection. Traditionally, surgical approaches have been through exploratory laparotomy or thoracotomy, subjecting already ill patients to additional morbidity.
Case Report:
We describe and demonstrate a laparoscopic minimally invasive approach to the management of a GPF with a wedge resection of the stomach, along with a review of the current literature regarding GPF treatment.
Conclusion:
GPF repair can be performed through laparoscopy and may lead to improved patient outcomes and faster recovery.
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References
1.
MarkowitzAM, HerterFP. Gastro-pleural fistula as a complication of esophageal hiatal hernia. Ann Surg, 1960; 152:129–134.
2.
TzengJJ, LaiKH, LoGH, HsuJH, MokKT. Gastropleural fistula caused by incarcerated diaphragmatic herniation of the stomach. Gastrointest Endosc, 2001; 53:382–384.
3.
VirlosI, AsimakopoulosG, Forrester-WoodC. Gastropleural fistula originating from the lesser curve: A recognized complication, an uncommon pathway of communication. Thorac Cardiovasc Surg, 2001; 49:308–309.
4.
AdachiY, SatoY, YasuiH, NishimuraS, TanumuraA, et al.Gastropleural fistula derived from malignant lymphoma. J Gastroenterol, 2002; 37:1052–1056.
5.
BiniA, GraziaM, PetrellaF, StellaF, BazzocchiR. Spontaneous biliopneumothorax (thoracobilia) following gastropleural fistula due to stomach perforation by nasogastric tube. Ann Thorac Surg, 2004; 78:339–341.
6.
CesarioA, GalettaD, MargaritoraS, TringaliA, PetruzzielloL, PorziellaV, et al.Persistent gastric stump-pleural fistula with circumscribed pleural empyema: A single approach for a twofold problem. Ann Thorac Surg, 2004; 78:56–57.
7.
MehranA, UklejaA, SzomsteinS, RosenthalR. Laparoscopic partial gastrectomy for the treatment of gastropleural fistula. JSLS, 2005; 9:213–215.
8.
TakedaS, FunakeS, YumibaT, OhnoK. Gastropleural fistula due to gastric perforation after lobectomy for lung cancer. Interact Cardiovasc Thorac Surg, 2005; 4:420–422.
9.
FongD, JajooK, PiesmanM, LautzD, ThompsonC. Endoscopic repair of gastropleural and gastroperitoneal fistulas with layered vicryl and fibrin glue. Gastrointest Endosc, 2007; 65:AB275.
10.
MuzaffarMS, UmairB, AsgharA, AliMZ, HanifMS, et al.Gastropleural fistula: An unusual sequel of blunt chest trauma. J Coll Physicians Surg Pak, 2009; 19:447–449.
11.
DiasOM, BarbosaCC, TeixeiraLR, VargasFS. Gastropleural fistula from gastric perforation due to renal cell carcinoma after bevacizumab chemotherapy: A case report. Clinics (Sao Paulo), 2011; 66:1495–1498.
BozkurtMA, KonesO, BasogluI, AlisH. Gastropleural fistula: A rare complication of ewing sarcoma. Korean J Thorac Cardiovasc Surg, 2013; 46:293–294.
14.
NeriA, LambertY, MarrelliD, Di MareG, MastrogiacomoD, et al.Gastro-pleuro-pericardial fistula following combined radiation and chemotherapy for lung metastases from renal cell carcinoma: Report of a case. Surg Today, 2013; 43:1457–1460.
15.
DohrmannT, KutupA, MahnerS, MullerV, JaenickeF, et al.Gastropleural fistula in a patient with recurrent ovarian cancer receiving combination therapy with carboplatin, gemcitabine, and bevacizumab. J Clin Oncol, 2013; 31:208–210.
16.
ArmstrongRL, HeysePB. Gastropleural fistula in metastatic ovarian cancer. J Surg Case Rep, 2014; 19:2014.
17.
ChowdaryPB, SadashivaiahSB, GangappaRB, ShivashankarSC. Gastro pleural fistula: A rare entity presenting as a complication of empyema thoracis following stab injury to the chest. J Clin Diagn Res, 2015; 9:PD05–PD06.
18.
Garcia-QuinteroP, Hernandez-MurciaC, RomeroR, DerosimoJ, GonzalezA. Gastropleural fistula after bariatric surgery: A report of two cases. J Robot Surg, 2015; 9:163–166.
19.
NguyenD, DipF, HendricksL, Lo MenzoE, SzomsteinS, et al.The Surgical management of complex fistulas after sleeve gastrectomy. Obes Surg, 2016; 26:245–250.
20.
Mendoza LaddA, Al-BayatiI, ShahP, HaberG. (2015) Endoscopic closure of a gastropleural fistula. Endoscopy, 47Suppl 1UCTN:E131-2.
21.
LuoRB, LiuS, DeLongJC, JacobsenGR, SandlerBJ, HorganS. Laparoscopic gastropleural fistula repair: A minimally invasive solution for a complex problem. J Laparosendosc Adv Surg Tech Videoscopy, 2017. DOI: 10.1089/vor.2016.0569.
