Open wound management of esophagocutaneous fistula in unstable cervical spine after corpectomy and multilevel laminectomy: A case report and review of the literature

Table 1 Cases reported in the literature

Ref.	No of patients with perforation	Time of diagnosis	Management	Outcome
Zhong et al[1]	6	Early postoperative	Wound debrided in 3 patients, implant removed and primary suture of perforation in 2 patients	5 healed 1 died due to pneumonia
Ardon et al[3]	4	Early postoperative in 3 patients	Hardware removed with primary suture of the perforation in 2 patients and in one of these an additional sternocleidomastoid myoplasty was done	3 healed 1 patient died due to systemic complication, indirectly related to the perforation
Yin et al[4]	1	3 yr after surgery	Emergency tracheostomy, hardware removal, abscess drainage and infected tissue debridement	Healed
Jamjoom et al[7]	1	Early postoperative	No definite perforation detected at reoperation, pharyngocutaneous fistula formed subsequently No attempted repair Open drainage in association with broad spectrum antibiotics, continuous nasopharyngeal suctioning, stopping of oral intake and gastrostomy feeding	Fistula recurred twice soon after resumption of oral feeding
Orlando et al[9]	5	2 during surgery 2 early postoperative 6 mo postoperative in 1	Hardware removal in 2 Hardware retained in 1 No hardware inserted in 2 Esophagus repaired in 4	All healed
Sun et al[10]	5	1 during surgery 4 early postoperative	Hardware removal in 2 Esophagus repaired in 4 reinforcement with a sternocleidomastoid muscle flap in 1 patient	All healed
Balmaseda et al[20]	1	Early postoperative	Hardware retained No repair	Healed
Ji et al[21]	1	Early postoperative	Hardware retained repaired and reinforced with sternocleidomastoid flap Recurrent esophageal leakage 2 d after the repair Wound reopened and a continuous irrigation and drainage system used	Healed