Surgical management of tracheoesophageal fistula

Osho, Asishana A.; Sachdeva, Uma M.; Wright, Cameron D.; Muniappan, Ashok

doi:10.21037/acs.2018.03.06

Cited by 6 publications

(7 citation statements)

References 6 publications

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“…However, endoscopic clipping therapy cannot effectively solve the larger TEF, and its surgical success rate is only 50% 15 . Currently, for resectable TEF, surgical resection is the gold standard for clinical treatment, and its success rate can be as high as ~ 90% 16 , 17 . The most commonly used surgical repair method in the clinic is the three-layer repair method, which involves repairing the tracheal fistula and esophageal fistula and inserting connective tissue into the tracheoesophageal space to cover the fistula to prevent recurrence.…”

Section: Discussionmentioning

confidence: 99%

Tracheoesophageal fistula treated with magnetic compression technique in canines

Zhang

Liu

et al. 2023

Sci Rep

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There are various surgical methods for tracheoesophageal fistula; however, there is presently no unified standard. Based on the magnetic compression technique, we designed a novel method for the treatment of tracheoesophageal fistula. The purpose of this study was to verify its feasibility in an animal experiment. Six beagle dogs underwent surgical repair after constructing a tracheoesophageal fistula model. After the tracheal and esophageal spaces were freed during the operation, two magnets were used to clamp the fistula. The operation time, intraoperative blood loss, postoperative complications, and wound healing were monitored. Samples were obtained 14 days after the operation, and fistula repair was observed. The tracheoesophageal fistula repair operation was successfully completed for all six beagles. The average operation time was 23.67 ± 4.50 min. The average intraoperative blood loss was less than 10 mL. One dog had a postoperative wound infection, and the rest had no postoperative complications. The wound healed well. In all dogs, after specimen collection, it was observed that the fistula was successfully closed and the mucosal layer was smooth and flat. Histological observation showed that the anastomosis was slightly inflamed, the mucosal layer and surrounding tissues were arranged neatly, and the structure was slightly disordered. Magnetic compression technique can be effectively used to repair tracheoesophageal fistula, shorten the operation time, and simplify the operation procedure, and thus, it has the potential for clinical application.

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Section: Discussionmentioning

confidence: 99%

Tracheoesophageal fistula treated with magnetic compression technique in canines

Zhang

Liu

et al. 2023

Sci Rep

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“…(B) The cartilaginous portion is repaired with interrupted absorbable suture with the knots tied on the outside. 6,7 Figure 9 If the fistula has associated tracheal stenosis or is >10 mm and not amenable to primary closure, tracheal resection is indicated. Anterior cervicotomy and dissection is performed as described above, without the transtracheal incision.…”

Section: Surgical Techniquementioning

confidence: 99%

“…The esophagus is repaired in the fashion above and an end-to-end tracheal anastomosis is performed, again with knots tied externally. 2,6,7 (B) After the posterior membranous tracheal anastomosis is completed, the cross-table ventilation endotracheal tube is removed and an orotracheal tube is guided across the anastomosis with the cuff placed distally in the airway. When the anastomoses are complete, esophagoscopy is performed to ensure the integrity of the esophageal repair.…”

Section: Surgical Techniquementioning

confidence: 99%

“…The trachea is only dissected out circumferentially at the site of the fistula to avoid devascularization or injury to the recurrent laryngeal nerve. No effort should be made to visualize the recurrent laryngeal nerve 2,6,7.…”

mentioning

confidence: 99%

“…Attempts should be made to keep resection <4 cm to avoid tension on the tracheal anastomosis. The esophagus is repaired in the fashion above and an end-to-end tracheal anastomosis is performed, again with knots tied externally 2,6,7. (B) After the posterior membranous tracheal anastomosis is completed, the cross-table ventilation endotracheal tube is removed and an orotracheal tube is guided across the anastomosis with the cuff placed distally in the airway.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Benign Tracheal Esophageal Fistula

Elser

Frederick

Penn

et al. 2020

Operative Techniques in Thoracic and Cardiovascular Surgery

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Minimally invasive palliative treatment of malignant tracheoesophageal fistula using cardiac septal occluder

Teng,

Zhou,

Xiong

et al. 2024

Langenbecks Arch Surg

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Introduction Tracheoesophageal fistula (TEF) especially malignant TEF (mTEF) is an uncommon yet critical medical condition necessitating immediate intervention. This life-threatening condition frequently manifests in critically ill patients who are dependent on prolonged mechanical ventilation and are unsuitable candidates for thoracotomy due to their compromised health status. The Management of these mTEF patients remain a significant challenge.This study aimed to evaluate the safety and efficacy of using a cardiac septal occluder for the closure of mTEF. Methods 8 patients with mTEF underwent closure surgery using atrial/ventricular septal defect (ASD/VSD) septal occluders at the Respiratory Department of HuBei Yichang Central People’s Hospital from 2021 to 2023. The procedure involved percutaneous placement of the occluder through the fistula to achieve closure. Results The placement of the cardiac septal occluder was successfully achieved with ease and efficiency in all patients. The study demonstrated that the use of cardiac septal occluder therapy in patients with mTEF can alleviate symptoms, improve quality of life, and enhance survival rates, with no significant complications observed. Furthermore, the study provided comprehensive details on surgical indications, preoperative evaluation and diagnosis, selection of occluder, methods of occlusion, and postoperative care. Conclusions The application of cardiac septal occluder in the treatment of mTEF is a safe and effective palliative treatment. This approach may be particularly beneficial for patients with a high risk of complications and mortality associated with traditional surgical interventions.

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Surgical management of tracheoesophageal fistula

Cited by 6 publications

References 6 publications

Tracheoesophageal fistula treated with magnetic compression technique in canines

Tracheoesophageal fistula treated with magnetic compression technique in canines

Benign Tracheal Esophageal Fistula

Minimally invasive palliative treatment of malignant tracheoesophageal fistula using cardiac septal occluder

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