Dogar Samie Asghar, Hamid Mohammad
Department of Anaesthesiology, Aga Khan University Hospital, Karachi.
J Pak Med Assoc. 2016 Sep;66(9):1176-1178.
Iatrogenic Tracheo Esophageal Fistula (TEF) in adults is a rare complication occurring secondary to trauma and prolonged intubation. There is very scarce data regarding its airway management and that too is from the paediatric age group. We describe the case of a young male undergoing TEF repair. We started with routine tracheal intubation but during surgery our tracheal tube was hindering surgical repair. So we used intermittent ventilation by passing the tracheal tube distal to the fistula and then pulling it back and providing clear surgical field during apnoea. It was done several times until the repair was completed successfully. Different airway management techniques are described in literature with the most common being oral intubation and placement of cuff distal to the fistula. However it may need to be modified according to the situation. We used a different technique for ventilation and will discuss it's pros and cons.
成人医源性气管食管瘘（TEF）是一种继发于创伤和长期插管的罕见并发症。关于其气道管理的数据非常稀少，且这些数据也来自儿科年龄段。我们描述了一例接受TEF修复手术的年轻男性病例。我们一开始进行常规气管插管，但在手术过程中气管导管妨碍了手术修复。于是我们通过将气管导管置于瘘口远端，然后将其撤回，并在呼吸暂停期间提供清晰的手术视野来进行间歇性通气。这样做了几次，直到成功完成修复。文献中描述了不同的气道管理技术，最常见的是经口插管并将套囊置于瘘口远端。然而，可能需要根据具体情况进行调整。我们采用了一种不同的通气技术，并将讨论其优缺点。
