RT Journal Article SR Electronic T1 Surgical Treatment of Intractable Cutaneous Fistula with Osteomyelitis in the Neck Developed after Esophagectomy JF Anticancer Research JO Anticancer Res FD International Institute of Anticancer Research SP 4359 OP 4364 VO 27 IS 6C A1 TAKESHI SHIMAKAWA A1 YOSHIHIKO NARITAKA A1 SHINICHI ASAKA A1 NORIYUKI ISOHATA A1 MINORU MURAYAMA A1 SOICHI KONNO A1 TAKAO KATSUBE A1 KENJI OGAWA A1 HIROKO IDE YR 2007 UL http://ar.iiarjournals.org/content/27/6C/4359.abstract AB A case of intractable cutaneous fistula in an esophagogastrostomized region complicated by osteomyelitis is reported. A three-stage operation was performed, and gratifying results were obtained. The patient was a 74-year-old man who received a subtotal esophagectomy and a cervical esophagogastrostomy through a retrosternal approach for advanced esophageal cancer. Following subsequent radiotherapy, the anastomosed region in the neck was found to have been stenosed. Endoscopic balloon dilatation was then performed and perforation of the stenosed region occurred to form an intractable fistula. A chest computed tomography scan revealed osteolysis of the sternum, clavicular head and left first rib. Treatment comprised an initial control of the infective foci including osteomyelitis and, after achieving stabilization of the wounds, the subsequent step of reconstruction. The patient's postoperative course was satisfactory without involvement of any leakage or stenosis of the anastomosed regions, or wound infection. It is considered feasible to cure even a cutaneous fistula in the neck complicated by osteomyelitis, as in the present case, by sufficient control of infection and procedural contrivance. Copyright© 2007 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved