VS02.03: LAPAROSCOPIC EXCISION OF ESOPHAGEAL FISTULA TRACT (LEEFT) IN A SPONTANEOUS ESOPHAGOCUTANEOUS FISTULA WITH KIKUCHI DISEASE

Abstract

Abstract Description Spontaneous esophagocutaneous fistula is rare and necrotizing mediastinal lymphadenopathy is one of the causes. We report a case of spontaneous esophagocutaneous fistula in a 38-year-old lady with Kikuchi disease that was treated with laparoscopic excision of esophageal fistula tract (LEEFT). On endoscopy, the fistula opening was located at right posterolateral wall of distal esophagus, 3cm above esophagogastric junction. Esophageal stenting and endoscopic clipping of fistula were attempted but the fistula tract persisted. She then underwent laparoscopic excision of esophageal fistula tract. Laparoscopic excision of esophageal fistula tract (LEEFT) is a novel transhiatal technique as compared to the usual transthoracic aproach. Patient is placed in french position and it is done via 4-laparoscopic port technique with liver retraction. LEEFT is feasible in distally located esophageal fistula. In comparison to transthoracic aproach, the dissection and control of esophagus is easier with this technique as dissection through the chronic inflammatory tissue in the posterior mediastinum is avoided. Moreover, it spares the morbidity associated with single lung ventilation and transthoracic approach. Disclosure All authors have declared no conflicts of interest.