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. 2024 Jan 26;30(1):22-00134.
doi: 10.5761/atcs.cr.22-00134. Epub 2022 Oct 29.

Post-Intubation Tracheoesophageal Fistula: Surgical Management by Complete Cervical Tracheal Transection

Dario Amore  1 , Dino Casazza  1 , Umberto Caterino  2 , Marco Rispoli  3 , Emanuele Muto  4 , Alessandro Saglia  5 , Carlo Curcio  1
Affiliations

Post-Intubation Tracheoesophageal Fistula: Surgical Management by Complete Cervical Tracheal Transection

Dario Amore et al. Ann Thorac Cardiovasc Surg. .

Abstract

We report successful surgical management of post-intubation tracheoesophageal fistula (TEF) in an adult patient requiring long-term mechanical ventilation. A complete tracheal transection without tracheal resection, via an anterior cervical approach, followed by direct closure of tracheal and esophageal defect, and interposition of muscle flap between the suture lines and tracheal reconstruction was performed. In selected cases, this surgical procedure may be a viable alternative to traditional techniques used to treat post-intubation TEF via the anterior or lateral cervical approach.

Keywords: alternative technique; surgery; tracheoesophageal fistula.

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Conflict of interest statement

We have no conflict of interest.

Figures

Fig. 1
Fig. 1. (A) Endoscopic visualization of the TEF (black arrows) from the trachea using flexible bronchoscopy. (B and C) Axial and sagittal chest computed tomography scans showing the TEF (red asterisk) at the level of the thoracic inlet. TEF: tracheoesophageal fistula; T: trachea
Fig. 2
Fig. 2. Intraoperative view of the TEF. (A) The retracted distal tracheal stump allows the identification of the esophageal (yellow arrow) and tracheal (white arrow) defects. (B) Closure of the esophageal defect with interrupted sutures (yellow arrow). TEF: tracheoesophageal fistula; tt: tracheal tube
Fig. 3
Fig. 3. Surgical procedure drawing. (A) Retraction of the distal tracheal stump after complete tracheal transection. (B and C) Direct closure of the esophageal and tracheal defects. (D) Tracheal reconstruction after mobilization of muscle flap.
See this image and copyright information in PMC

References

    1. Bibas BJ, Cardoso PFG, Minamoto H, et al. Surgery for intrathoracic tracheoesophageal and bronchoesophageal fistula. Ann Transl Med 2018; 6: 210. - PMC - PubMed
    1. Macchiarini P, Verhoye JP, Chapelier A, et al. Evaluation and outcome of different surgical techniques for postintubation tracheoesophageal fistulas. J Thorac Cardiovasc Surg 2000; 119: 268–76. - PubMed
    1. Dhiwakar M, Ronen O, Supriya M, et al. Surgical repair of mechanical ventilation induced tracheoesophageal fistula. Eur Arch Otorhinolaryngol 2020; 277: 323–31. - PubMed
    1. Elser T, Frederick A, Penn E, et al. Benign tracheal esophageal fistula. Oper Tech Thorac Cardiovasc Surg 2019; 25: 27–41.
    1. Muniappan A, Wain JC, Wright CD, et al. Surgical treatment of non-malignant tracheoesophageal fistula: a thirty-five year experience. Ann Thorac Surg 2013; 95: 1141–6. - PubMed

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