Background: Gastro-thoracic fistula is a serious complication after radical surgery for esophageal cancer, and a conservative approach or endoscopic intervention is commonly applied to treat most cases.
Core Tip: We report a patient whose gastro-thoracic fistula could not be closed surgically following radiotherapy, and who also presented with severe multiple drug-resistance bacterial infection and chest wall fistula. The patient was successfully treated by draining the abscess and applying local irrigation, as well as administering ozonated water orally. This case demonstrates that adequate local drainage and anti-infection treatment can be used to cure patients with severe infection and gastro-thoracic fistula which cannot be closed under endoscopy. As a supplement to conventional therapy, treatment using local irrigation with ozonated water to control infection can heal patients with this condition.
The incidence and mortality of esophageal cancer are high in China. Radical surgery is often the first-line treatment option for the majority of patients[1,2]. One type of life-threatening postoperative complication is gastro-thoracic fistula with an incidence of 14.1% worldwide[3,4], which may be associated with body mass index. Effective anti-infection treatment is the key to reducing mortality and improving patient quality of life.
Long-term clinical trials have proven that ozone can both effectively control infections caused by various bacteria, fungi, and viruses[6,7], and promote tissue repair. Here, we report a case of gastro-thoracic fistula after comprehensive treatment for esophageal cancer, complicated by severe thoracic infection, and successfully treated using ozone.