A simple and effective method for closure of enlarged tracheoesophageal puncture in seven patients

Gözen, Emine Deniz; Tevetoğlu, Fırat; Eker, Çağlar; Yener, Murat; Karaman, Emin

doi:10.1111/coa.13401

Cited by 4 publications

(18 citation statements)

References 10 publications

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“…Huang and Day established that multilayered closure supersedes a large quantity of fresh tissue in the form of grafts for reconstruction of communicating wounds. 9 To our knowledge, Lee and Razi was the first to report the interposition of the SCM muscle in one patient for TEP closure, 50 and Wasano et al proposed the interposition of SCM fascia between the esophagus and the trachea as an option to decrease the risk of relapse of the TEF. In the series reported by Wasano et al, excellent results were conveyed despite a 50% preoperative radiotherapy rate, as all 4 patients achieved resumption of oral intake and had a successful TEP closure without complications over a period of 11.5 months, perhaps due to the vascularized nature of a pedicled fascial flap.…”

Section: Discussionmentioning

confidence: 99%

“…32,38 Conversely, no TEP recurrence was reported in patients managed with a FFF or the lateral arm free flap despite 94% of patients having previous history of radiotherapy. 9,[24][25][26]33,52 Ten studies reported the size of the puncture diameter. 8,26,29,37,39,40,43,44,47,49 Remarkably, tracheal wall closure, fistula excision, and esophageal wall closure with or without interposition of a dermal graft or fascia lata (FL), was the most common reconstructive technique when defects were of 15 mm or less.…”

Section: Discussionmentioning

confidence: 99%

“…1). [8][9][10]12, Using the OCEBM, 33 studies had a level of evidence of 4. No discrepancies during quality assessment occurred.…”

Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

“…other conservative approaches such as replacement with silicone ring expanded prosthesis, 4 purse-string sutures, 5 hyperbaric oxygen therapy, 6 or injections of different substances such as autologous fat, 6 hyaluronic acid, 7 and granulocyte-macrophage colony-stimulating factor to reduce the diameter of the tracheoesophageal fistula (TEF) have been reported. 4,5,[8][9][10][11] Unfortunately, TEPs may persist despite conservative management and formal surgical closure may be indicated to avoid morbid consequences. 12 The purpose of this study was to systematically review the available evidence on the surgical methods employed for TEP closure focusing on outcomes and reported complications.…”

Section: Introductionmentioning

confidence: 99%

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Definitive Closure of the Tracheoesophageal Puncture Site after Oncologic Laryngectomy: A Systematic Review and Meta-Analysis

et al. 2022

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Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure.A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed.Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1–13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1–43%), 7% (95% CI < 1–34%) for dermal graft interposition, < 1% (95% CI < 1–37%) for radial forearm free flap, < 1% (95% CI < 1–52%) for ligation of the fistula, 17% (95% CI < 1–64%) for interposition of a deltopectoral flap, 9% (95% CI < 1–28%) for primary closure, and 2% (95% CI < 1–20%) for interposition of a sternocleidomastoid muscle flap.Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…1). [8][9][10]12, Using the OCEBM, 33 studies had a level of evidence of 4. No discrepancies during quality assessment occurred.…”

Section: Literature Search and Quality Assessmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Definitive Closure of the Tracheoesophageal Puncture Site after Oncologic Laryngectomy: A Systematic Review and Meta-Analysis

et al. 2022

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“…In fact, the incidence of leakage around a speech prosthetic valve following TEP enlargement is acknowledged to be between 1 and 29% with a 3-fold increased risk of aspiration pneumonia, a 20 to 30% mortality rate, and 14% long-lasting requirements of nutritional support via percutaneous gastrostomy. 42 43 44 Therefore, for young patients with better prognosis, no comorbidities, and long life expectancy, the ICFF is a fair alternative. For older patients or patients with poor prognosis, a skin flap with voice prosthesis can be considered as in initial choice.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Pharyngolaryngeal Defects with the Ileocolon Free Flap: A Comprehensive Review and How to Optimize Outcomes

et al. 2022

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Several reconstructive methods have been reported to restore the continuity of the aerodigestive tract following resection of pharyngeal and hypopharyngeal cancers. However, high complication rates have been reported after voice prosthesis insertion. In this setting, the ileocolon free flap (ICFF) offers a tubularized flap for reconstruction of the hypopharynx while providing a natural phonation tube. Herein, we systematically reviewed the current evidence on the use of the ICFF for reconstruction of the aerodigestive tract. A systematic literature search was conducted across PubMed MEDLINE, Web of Science, ScienceDirect, Scopus, and Ovid MEDLINE(R). Data on the technical considerations and surgical and functional outcomes were extracted. Twenty-one studies were included. The mean age and follow-up were 54.65 years and 24.72 months, respectively. An isoperistaltic or antiperistaltic standard ICFF, patch flap, or chimeric seromuscular-ICFF can be used depending on the patients' needs. The seromuscular chimeric flap is useful to augment the closure of the distal anastomotic site. The maximum phonation time, frequency, and sound pressure level (dB) were higher with ileal segments of 7 to 15 cm. The incidence of postoperative leakage ranged from 0 to 13.3%, and the majority was occurring at the coloesophageal junction. The revision rate of the microanastomosis ranged from 0 to 16.6%. The ICFF provides a reliable and versatile alternative for reconstruction of middle-size defects of the aerodigestive tract. Its three-dimensional configuration and functional anatomy encourage early speech and deglutition without a prosthetic valve and minimal donor-site morbidity.

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Surgical closure of enlarged tracheoesophageal fistula after laryngectomy: A systematic review of techniques

Lane,

Wright,

Linton

et al. 2024

American Journal of Otolaryngology

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A simple and effective method for closure of enlarged tracheoesophageal puncture in seven patients

Cited by 4 publications

References 10 publications

Definitive Closure of the Tracheoesophageal Puncture Site after Oncologic Laryngectomy: A Systematic Review and Meta-Analysis

Definitive Closure of the Tracheoesophageal Puncture Site after Oncologic Laryngectomy: A Systematic Review and Meta-Analysis

Reconstruction of Pharyngolaryngeal Defects with the Ileocolon Free Flap: A Comprehensive Review and How to Optimize Outcomes

Surgical closure of enlarged tracheoesophageal fistula after laryngectomy: A systematic review of techniques

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