J Chest Surg.  2021 Jun;54(3):206-213. 10.5090/jcs.21.012.

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

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Ewha Womans University Seoul Hospital, Seoul, Korea
  • 2Department of Thoracic and Cardiovascular Surgery, Inje University Busan Paik Hospital, Busan, Korea
  • 3Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Yangsan, Korea

Abstract

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.

Keyword

Tracheoesophageal fistula; Trachea; Esophagus; Tracheal resection
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