Video-assisted thoracoscopic surgical management of benign esophago-pulmonary fistula

ABSTRACT: Benign esophago-pulmonary fistula (EPF) is a rare clinical condition. This report highlights the case of a 58-year-old woman with a 10-year history of recurrent episodes of cough, throat irritation, dyspepsia and recurrent haemoptysis. Upper gastrointestinal (GI) endoscopy and chest CT detected a fistulous communication between the mid-oesophagus and the right lower lobe lung parenchyma, with bronchiectatic changes in the lower lobe. This patient underwent a video-assisted thoracoscopic surgery (VATS) division of EPF with right lower lobectomy. Intraoperatively, the fistula was identified on esophagoscopy and was divided after ensuring complete fistula closure without compromising the oesophageal lumen. She had an uneventful recovery in the postoperative period. This case highlights the importance of a minimally invasive VATS approach in managing complex benign thoracic fistulas, offering reduced morbidity and faster recovery compared to open thoracotomy.