PMC5755238_01
(A) Metal stent seen during thoracotomy. (B) Cervical fistula seen during esophagogram. (C) Cervical fistula seen during upper endoscopy.
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Redo operation was performed and at thoracotomy an anastomotic leak, with free purulent fluid in the pleural cavity was found (Fig. 1A). A new esophagogram was done and an esophago-colonic anastomosis leak was discovered (Fig. 1B). An upper endoscopy was performed, localizing the fistula of 12 x 6 mm (Supplementary Video & Fig. 1C).
(A) Functional V.A.C. system in-patient. (B) Granulation tissue in the cervical wound. (C) Wound after therapy.
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The adhesive drape was fixed to the neck skin and continuous suction between 100 and 125 mmHg was installed (Fig. 2A). In the first week, V.A.C. system drained about 50cc of saliva-like fluid daily and was changed every 2 days, once granulation tissue had begun to form over the wound, the system was changed every 5 days and no paraffin gauze was used (Fig. 2B). On follow-up controls, the patient was in good condition (Fig. 2C).