Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2020; 8(19): 4550-4557
Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4550
Application of ozonated water for treatment of gastro-thoracic fistula after comprehensive esophageal squamous cell carcinoma therapy: A case report
De-Di Wu, Ke-Nan Hao, Xiao-Jing Chen, Xin-Min Li, Xiao-Feng He
De-Di Wu, Ke-Nan Hao, Xiao-Jing Chen, Xin-Min Li, Xiao-Feng He, Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Author contributions: Wu DD wrote the paper and collected the patient’s clinical data; Hao KN and Chen XJ administrated and followed the patient; Li XM performed the operation and approved the publication of the paper; He XF made critical revisions to the paper and designed the operation.
Supported by Foundation of President of Nanfang Hospital, Southern Medical University.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: There are no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xiao-Feng He, MD, Chief Doctor, Professor, Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou 510515, Guangdong Province, China. ozonetherapy@126.com
Received: May 9, 2020
Peer-review started: May 9, 2020
First decision: May 15, 2020
Revised: May 28, 2020
Accepted: August 25, 2020
Article in press: August 25, 2020
Published online: October 6, 2020
Abstract
BACKGROUND

Gastro-thoracic fistula is a serious complication after radical surgery for esophageal cancer, and a conservative approach or endoscopic intervention is commonly applied to treat most cases.

CASE SUMMARY

Here we describe the case of a patient with a gastro-thoracic fistula which could not be closed during gastroscopy after receiving postoperative radiotherapy, together with severe multiple drug-resistant bacterial infection and chest wall fistula. The abscess was drained and local irrigation applied with ozonated water, together with oral ozonated water, which achieved a good effect and highlighted a new way to cure fistula in such patients.

CONCLUSION

Patients with gastro-thoracic fistula that cannot be closed and severe infection can be treated by drainage and flushing with ozonated water.

Keywords: Esophageal squamous cell carcinoma, Ozonated water, Radiotherapy, Gastro-thoracic fistula, Drug-resistant bacterial infection, Case report

Core Tip: We report a patient whose gastro-thoracic fistula could not be closed surgically following radiotherapy, and who also presented with severe multiple drug-resistance bacterial infection and chest wall fistula. The patient was successfully treated by draining the abscess and applying local irrigation, as well as administering ozonated water orally. This case demonstrates that adequate local drainage and anti-infection treatment can be used to cure patients with severe infection and gastro-thoracic fistula which cannot be closed under endoscopy. As a supplement to conventional therapy, treatment using local irrigation with ozonated water to control infection can heal patients with this condition.