Endoscopically assisted transstomal primary repair of an acquired tracheoesophageal fistula

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

“…Several surgical approaches are described in the literature ranging from endoscopically assisted surgery with direct suture to open surgical techniques such as primary repair and tracheal resection and anastomosis or lateral cervical approaches with direct closure of trachea and esophagus with or without interposition of a pedicled muscle flap or synthetic patch or fascia [5,[14][15][16][17][18][19][20]. Non-surgical approaches, such as the use of a self-expanding esophageal stent and endoscopic glue, have also been proposed [22].…”

Slide Tracheoplasty for Repair of Complex Tracheoesophageal Fistulas

“…There are many causes for acquired TEFs including prolonged or ill-fitting tracheostomy use, esophageal foreign bodies or button batteries, corrosive ingestion, iatrogenic injuries following tracheostomy or endotracheal intubation, and erosion due to airway or esophageal stents. [10][11][12][13][14][15][16][17][18][19][20][21] These acquired fistulas can range in size from millimeters to several centimeters and can occur at any point along the trachea or bronchi, which creates unique challenges in determining an optimal surgical approach. While small, narrow fistulas may be approached endoscopically, 9,20,[22][23][24][25] larger fistulas will require an open procedure.…”

“…[10][11][12][13][14][15][16][17][18][19][20][21] These acquired fistulas can range in size from millimeters to several centimeters and can occur at any point along the trachea or bronchi, which creates unique challenges in determining an optimal surgical approach. While small, narrow fistulas may be approached endoscopically, 9,20,[22][23][24][25] larger fistulas will require an open procedure. A variety of different techniques have been reported including ligation with division via transcervical or thoracotomy approach, 3,8,18,21 esophageal transection and patching through a thoracotomy, 16,19 tracheal resection with primary esophageal closure, 17,26 and esophageal diversion or replacement.…”

“…TEFs can also be found outside of the neonatal period, either due to acquired causes or later recognition of congenital H‐type fistulas. There are many causes for acquired TEFs including prolonged or ill‐fitting tracheostomy use, esophageal foreign bodies or button batteries, corrosive ingestion, iatrogenic injuries following tracheostomy or endotracheal intubation, and erosion due to airway or esophageal stents 10–21 . These acquired fistulas can range in size from millimeters to several centimeters and can occur at any point along the trachea or bronchi, which creates unique challenges in determining an optimal surgical approach.…”