Surgical repair of mechanical ventilation induced tracheoesophageal fistula

Dhiwakar, Muthuswamy; Ronen, Ohad; Supriya, Mrinal; Mehta, Shivprakash

doi:10.1007/s00405-019-05723-y

Cited by 8 publications

(13 citation statements)

References 44 publications

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“…Mortality and morbidity outcomes with our surgical technique were satisfactory and comparable to existing literature [7,8,13,15]. Mortality in the various series range between 0-33%, whereas our series saw no mortality.…”

Section: Discussionsupporting

confidence: 83%

“…Mortality in the various series range between 0-33%, whereas our series saw no mortality. Similarly, the fistula healing rate and appliance-free trachea were achieved in about 33-100% across the literature; this was 100% in our series at a six-month follow-up [7]. In the immediate postoperative period, 90% of our patients had an excellent outcome regarding fistula repair, except for one patient who developed esophageal leak.…”

Section: Discussionsupporting

confidence: 67%

“…Postintubation TEF usually involves the cervical or upper thoracic esophagus; hence, it can be easily approached from the left neck. Tracheal resection and anastomosis with primary esophageal closure was recommended as the preferred procedure in some series while a more conservative approach of the simple repair was advocated in others [7]. However, tracheal resection and anastomosis are associated with increased morbidity and should be reserved for patients with concomitant tracheal stenosis or patients with extensive damage to the posterior tracheal wall.…”

Section: Discussionmentioning

confidence: 99%

“…Two different approaches were described: the anterior approach and the lateral approach [5,6]. Each has its advantages, disadvantages, and limitations [7]. We describe our novel surgical technique, a form of lateral approach for TEF repair with technical modification.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Stapled Repair of Benign Acquired Tracheoesophageal Fistula: Description of Novel Technique and Assessment of Outcomes

Gurram¹,

Gnanasekaran²,

Kalayarasan³

et al. 2020

Cureus

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Compared to less invasive measures, surgical repair is the most effective modality for managing benign acquired tracheoesophageal fistula (TEF). Traditionally, this involves dismantling of the fistula and suture repair of tracheal and esophageal defects using a lateral or direct approach. However, the best approach remains a subject of debate. We describe a novel and simple technique for dismantling a benign acquired TEF with the use of an endo-stapler and interposition with sternocleidomastoid (SCM) muscle flap. Eleven TEF patients underwent repair using this stapled repair technique. Retrospectively, the perioperative and long-term outcomes were assessed in these patients. There were no cases of procedure-related mortality or airway-related complications. Two patients developed transient vocal cord palsy and one developed esophageal leak. At a mean follow-up of 21.4 months, no fistula recurrence, dysphagia, or tracheal stenosis was observed. Hence stapled dismantling and SCM muscle interposition is a simple and safe technique for repair of benign acquired TEF.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Stapled Repair of Benign Acquired Tracheoesophageal Fistula: Description of Novel Technique and Assessment of Outcomes

Gurram¹,

Gnanasekaran²,

Kalayarasan³

et al. 2020

Cureus

View full text Add to dashboard Cite

show abstract

“…It is, thus, recommended that these criteria be applied for patients with TEF in general; however, in exceptional cases, the surgical method should be determined according to the specific case. Dhiwakar et al [ 19 ] proposed a flow chart for surgical decision-making based on a review of descriptions from throughout the world, and suggested that primary repair should be selected if the fistula size is >5 cm because it is impossible to perform tracheal resection. We reported 1 such example in the current study.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment Outcomes of Acquired Benign Tracheoesophageal Fistula: A Literature Review

Kim

Lee

et al. 2021

J Chest Surg

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Background: Tracheoesophageal fistula (TEFs) is a rare condition that requires complex surgical treatment. We analyzed the surgical outcomes of TEF reported in the literature and at Pusan National University Yangsan Hospital using standardized techniques. Methods: This retrospective study included 8 patients diagnosed with acquired benign TEF between March 2010 and December 2019. The surgical method was determined based on the size of the fistula observed within the endoscope. Results: TEF occurred in 7 patients (87.5%) after intubation or tracheostomy and in 1 patient (12.5%) after esophageal surgery due to conduit necrosis. For tracheal management, 5 and 2 patients underwent tracheal resection and end-to-end anastomosis and primary repair, respectively. The median length of resection was 2.5 cm (range, 1.3-3.4 cm). For esophageal management, 6 patients underwent primary repair and 1 patient underwent esophageal diversion. One patient underwent TEF division with a stapler. Interposition of a muscle flap was performed in 2 patients. TEF recurrence, esophageal stenosis, and dehiscence or granulation occurred in 1, 1, and 2 patients, respectively. A long-term tracheostomy tube or T-tube was used in 2 patients for >2 months. Conclusion: Although TEF surgery is complex and challenging, good results can be achieved if surgical standards are established and experience is accumulated.

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Surgical management of benign cervical tracheoesophageal fistulas: A single-tertiary academic institution experience

Fermi

Manto

Ferri

et al. 2021

American Journal of Otolaryngology

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Surgical repair of mechanical ventilation induced tracheoesophageal fistula

Cited by 8 publications

References 44 publications

Stapled Repair of Benign Acquired Tracheoesophageal Fistula: Description of Novel Technique and Assessment of Outcomes

Stapled Repair of Benign Acquired Tracheoesophageal Fistula: Description of Novel Technique and Assessment of Outcomes

Surgical Treatment Outcomes of Acquired Benign Tracheoesophageal Fistula: A Literature Review

Surgical management of benign cervical tracheoesophageal fistulas: A single-tertiary academic institution experience

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