Department of Thoracic Surgery, Monaldi Hospital, Naples, Italy.
Department of Anesthesia and Intensive Care, Monaldi Hospital, Naples, Italy.
Ann Thorac Cardiovasc Surg. 2022 Dec 20;28(6):377-380. doi: 10.5761/atcs.nm.22-00077. Epub 2022 Sep 3.
We present a case of surgical management of a tracheoesophageal fistula (TEF) following prolonged intubation. After transverse tracheal division and retraction of the distal stump, direct closure of the esophageal defect and repair of the membranous tracheal defect using a synthetic bioabsorbable patch were performed, followed by interposition of muscle flap between the suture lines and tracheal reconstruction. Large TEFs, without tracheal stenosis or circumferential airway defect, associated with marked peritracheal inflammation, may be treated with this alternative tracheoplastic technique in patients deemed not suitable for tracheal resection and anastomosis.
我们报告了一例因长时间插管导致的气管食管瘘(TEF)的手术治疗。在横向气管切开和远端残端牵引后,使用合成可吸收补片直接关闭食管缺损,并修复膜性气管缺损,然后在缝线之间插入肌肉瓣进行气管重建。对于与明显的气管周围炎症相关的、无气管狭窄或环形气道缺损的大 TEF 患者,如果认为不适合进行气管切除和吻合术,则可以使用这种替代气管成形技术进行治疗。