Authors
Joris A van Dongen, Roos E Pouw, Metin Bülbül, Hans J L Kemming, J Henk Coert, Richard van Hillegersberg
Published in
VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy. Volume 11. Issue 2. Pages 37-40. Epub Oct 09, 2025.
Abstract
Bronchoesophageal fistula (BEF) is a rare but life-threatening adverse event following surgery. Fistulas result in respiratory adverse events, often requiring surgical repair, which is a high-risk procedure. Therefore, minimally invasive alternatives are needed. We aimed to use adipose-derived stromal vascular fraction (SVF) to treat BEFs.
We present 2 BEF cases after minimally invasive esophagectomy and gastric conduit reconstruction. During the procedure, SVF was isolated and platelet-rich plasma (PRP) obtained. In 1 case with a tracheaesophageal fistula, simultaneous bronchoscopy and endoscopy were performed to localize and treat the fistula; in the second case, only gastroscopy was performed to treat a fistula from the esophagus to the right upper lobe. During the procedures, the epithelialized fistula tract was cleared using brushing and argon plasma coagulation, followed by injection of SVF-PRP around the fistula. Closure was obtained using a through-the-scope suturing system.
The patients recovered well, and an esophagram 4 weeks postprocedure showed no more signs of a fistula. Currently, 7 and 4 months postprocedure, respectively, both patients are on a normal oral diet and with restored pulmonary function.
These cases demonstrate that SVF-PRP injection combined with endoscopic closure may offer a promising minimally invasive alternative for BEF treatment.
PMID:
41727389
Bibliographic data and abstract were imported from PubMed on 06 Oct 2026.
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