Chandra T Satish, Sadhana O, Sameera G, Murthy P S N, Dimple A
Department of ENT, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation (PSIMS and RF), Chinnautapalli, Gannavaram, Andhrapradesh India.
Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):6039-6044. doi: 10.1007/s12070-021-02682-x. Epub 2021 Jun 15.
Acquired Tracheo-esophageal fistula (TEF) is a challenging and complicated condition. The laryngeal protection is lost in acquired TEF cases due to the established connection between the esophagus and the airways leading to aspiration, pneumonia, and acute respiratory distress syndrome. Malignancy contributes to about 80% of acquired TEF. Nonmalignant causes for TEF include prolonged ventilation, trauma (iatrogenic, penetrating, or blunt injury), foreign bodies, corrosive burns, and granulomatous infections. With the advancements in critical care, the incidence of TEF post-ventilation is on the rise in recent decades. We would like to share our experience managing ten cases of nonmalignant acquired cervical TEF by the lateral cervical approach at our institute. Apart from the isolated TEF cases, one patient with concomitant tracheal stenosis was repaired simultaneously with good postoperative results. TEF was identified in two cases following removal of T-tube and solid stent respectively and was repaired successfully with lateral cervical approach with strap muscle flap interposition.
后天性气管食管瘘（TEF）是一种具有挑战性且复杂的病症。由于食管与气道之间已建立连接，导致误吸、肺炎和急性呼吸窘迫综合征，后天性TEF病例会丧失喉保护功能。恶性肿瘤约占后天性TEF的80%。TEF的非恶性病因包括长时间通气、创伤（医源性、穿透性或钝性损伤）、异物、腐蚀性烧伤和肉芽肿性感染。随着重症监护技术的进步，近几十年来通气后TEF的发病率呈上升趋势。我们想分享我们在本研究所通过颈侧入路处理10例非恶性后天性颈段TEF的经验。除了孤立的TEF病例外，1例合并气管狭窄的患者同时进行了修复，术后效果良好。分别在取出T形管和固体支架后，2例患者被诊断出TEF，并通过颈侧入路加带状肌瓣置入成功修复。
