{
  "abstract": "Once an esophago–airway fistula develops during chemoradiotherapy for cT4b esophageal cancer, further curative treatment is often precluded. We describe a robotic technique for closure of a large esophago–left main bronchial fistula using a pedicled autologous pericardial patch reinforced with a latissimus dorsi muscle flap. A 66-year-old woman with squamous cell carcinoma of the middle to upper thoracic esophagus invading the left main bronchus developed a fistula after definitive chemoradiotherapy. After temporary airway stenting, salvage surgery was performed in the semi-prone position under single-lung ventilation and CO₂ pneumothorax. Following thoracic esophagectomy, a horseshoe-shaped pedicled pericardial patch was created robotically, flipped cranially, and sutured to the bronchial defect. A right latissimus dorsi muscle flap was then introduced into the right thoracic cavity through a second intercostal opening and robotically fixed over the repair. To our knowledge, this is the first report of this robotic technique.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10388-026-01235-x.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Gastroenterological Surgery, The University of Osaka Graduate School of Medicine, 2-2-E2, Yamada-Oka, Suita, Osaka 565-0871 Japan",
    "Department of Gastroenterological Surgery, Sakai City Medical Center, Osaka, Japan",
    "Department of Plastic Surgery, The University of Osaka Graduate School of Medicine, Suita, Osaka Japan",
    "Department of General Thoracic Surgery, The University of Osaka Graduate School of Medicine, Suita, Osaka Japan",
    "Department of Cardiovascular Surgery, The University of Osaka Graduate School of Medicine, Suita, Osaka Japan",
    "Department of Gastroenterological Surgery, Osaka General Medical Center, Osaka, Japan"
  ],
  "article_type": "brief report",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Tomoki Makino",
      "orcid": "0000-0001-7918-4217"
    },
    {
      "affs": [
        0
      ],
      "name": "Shigeto Nakai"
    },
    {
      "affs": [
        1
      ],
      "name": "Tomohira Takeoka"
    },
    {
      "affs": [
        0
      ],
      "name": "Kotaro Yamashita"
    },
    {
      "affs": [
        2
      ],
      "name": "Kazuya Kuroda"
    },
    {
      "affs": [
        0
      ],
      "name": "Koji Tanaka"
    },
    {
      "affs": [
        3
      ],
      "name": "Takashi Kanou"
    },
    {
      "affs": [
        2
      ],
      "name": "Tateki Kubo"
    },
    {
      "affs": [
        3
      ],
      "name": "Yasushi Shintani"
    },
    {
      "affs": [
        4
      ],
      "name": "Shigeru Miyagawa"
    },
    {
      "affs": [
        0
      ],
      "name": "Hidetoshi Eguchi"
    },
    {
      "affs": [
        0,
        5
      ],
      "name": "Yuichiro Doki"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3yef6hwjhjdqe.bib",
  "cited_by": 0,
  "doi": "10.1007/s10388-026-01235-x",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13723538/",
  "id": "3yef6hwjhjdqe",
  "issns": [
    "1612-9059",
    "1612-9067"
  ],
  "landing_url": "https://doi.org/10.1007/s10388-026-01235-x",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "How I Do It"
    ],
    [
      "openalex",
      "2746|Esophageal and GI Pathology"
    ]
  ],
  "openalex": "W7204498636",
  "pdf_url": "https://link.springer.com/content/pdf/10.1007/s10388-026-01235-x.pdf",
  "pmcid": "PMC13723538",
  "pmid": "42663916",
  "published": "2026-08-28",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3yef6hwjhjdqe.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T12:22:09Z",
      "native_id": "PMC13723538",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s10388-026-01235-x"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Esophageal and GI Pathology",
      "subfield": "surgery"
    }
  ],
  "title": "Robotic repair of an esophago–left main bronchial fistula using a pedicled autologous pericardial patch and latissimus dorsi muscle flap: a novel technique after chemoradiotherapy for cT4b esophageal cancer",
  "title_text": "Robotic repair of an esophago–left main bronchial fistula using a pedicled autologous pericardial patch and latissimus dorsi muscle flap: a novel technique after chemoradiotherapy for cT4b esophageal cancer",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:20Z",
  "url": "https://research.draconitic.com/paper/3yef6hwjhjdqe",
  "venue": "Esophagus",
  "versions": []
}