Successful Endoscopic Removal of a Kerh-Tube Placed in an Iatrogenic Esophageal Perforation: Push to Pull

Abstract

Esophageal perforation is a rare complication during cervical surgery associated with high morbidity and mortality. Currently, the treatment of esophageal perforations remains controversial. The use of modified T-tube (Kerh-tube) repair can be a therapeutic option associated with a low mortality rate. The authors report a 68-year-old man with a cervical spinal cord lesion submitted to an anterior cervical surgery when a plate fixation removal complicated with an iatrogenic cervical esophageal perforation that was immediately diagnosed. A T-tube was inserted into the esophagus following debridement of adjacent wall with its inferior portion extending into the stomach. The esophageal wall was closed loosely about the tube with sutures placed in the nearest healthy submucosa (Figs. 1 and 2A and B). Two weeks later, an upper endoscopy was performed in order to remove the T-tube. Using a polypectomy snare (10 mm, Olympus) the distal end of the Kerh-tube was