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J Thorac Cardiovasc Surg 2009;137:813-817
© 2009 The American Association for Thoracic Surgery

General Thoracic Surgery

Repair of massive stent-induced tracheoesophageal fistula

Yong Han, MD, Kun Liu, MD, Xiaofei Li, MD, Xiaoping Wang, MD, Yongan Zhou, MD, Zhongping Gu, MD, Qunfeng Ma, MD, Tao Jiang, MD, Lijun Huang, MD, Tao Zhang, MD, Qingshu Cheng, MD*

Department of Thoracic Surgery, Tangdu Hospital of The Fourth Military Medical University, Xi'an, Shaanxi, China

Received for publication February 2, 2008; revisions received June 2, 2008; accepted for publication July 5, 2008.

* Address for reprints: Qingshu Cheng, MD, Department of Thoracic Surgery Tangdu Hospital, The Fourth Military Medical University, Xi'an 710038 China. (Email: chechest{at}fmmu.edu.cn).

Objective: The purpose of this report was to discuss a new surgical procedure in treating esophageal stent related large tracheoesophageal fistula without tracheal resection.

Methods: Clinical records of 5 patients with esophageal stent-related large tracheoesophageal fistulas treated in this hospital between 1997 and 2006 were reviewed.

Result: All patients had insertion of a covered self-expanding esophageal stent, 1 for benign esophageal stricture and 4 for esophageal perforation resulting from various causes. A double patch technique, in which the esophageal wall was used as a protective patch repairing the defect on the trachea, was performed with an esophagectomy and gastric replacement. No significant complications occurred in the perioperative period. All patients recovered uneventfully.

Conclusions: Use of the adjacent esophageal wall as a patch to close a defect on the trachea is a safe procedure with a favorable outcome. It should therefore be recommended as a reliable surgical procedure in treating massive stent-induced tracheoesophageal fistulas and other complicated tracheoesophageal fistulas that tracheal resection could not safely address. However, the esophagus was damaged to a certain degree.

Abbreviation and Acronym TEF = tracheoesophageal fistula






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