A simple method for closure of tracheocutaneous fistula in children

Abstract

Objective: To review the results of a simple technique of closure of persistent tracheocutaneous fistula (TCF) in children.

Design: Retrospective case series.

Setting: Tertiary pediatric otolaryngology referral center.

Patients: Children (age, < 18 years) who underwent repair of TCF from July 1, 1991, to August 31, 1996.

Interventions: Surgical closure of persistent TCF using multilayered closure of de-epithelialized local tissue. Tracheal dissection was not performed. A thermal hemostatic scalpel was used in some cases to assist in de-epithelialization and provide hemostasis without electrocautery near the airway.

Main outcome measures: Success of closure and number and types of complications.

Results: Nine procedures were performed in 8 children. Seven (88%) of 8 primary procedures were successful, but early recurrent TCF developed in 1 patient. Revision surgery using an identical surgical technique, but maintaining endotracheal intubation for 48 hours, was successful in this patient. No complications occurred.

Conclusions: This procedure is a simple, reliable method for closure of TCF in children.