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Successful Treatment by Tracheal Resection and Primary Repair With Four-Year Follow-up

Alexander S. Geha, MD; James V. Seegers, MD; Ira J. Kodner, MD; Stephan Lefrak, MD

Arch Surg. 1978;113(3):338-340.

Abstract
• A tracheoesophageal fistula secondary to prolonged nasogastric intubation and ventilatory assistance via a cuffed tracheostomy tube developed in a 27-year-old woman who had sustained a traumatic injury. The fistula grew progressively larger despite removal of the tubes, thus demonstrating the inherent poor prognosis associated with the untreated lesion. Since the cuff necessarily damages the trachea circumferentially at the same level, closure of the fistula and circumferential excision and reconstruction of the damaged tracheal wall were performed with an excellent result up to four years after the repair. This would be the preferred procedure when the patient can be weaned off the respirator and when the general condition and the size of the fistula allow such a definitive one-stage approach.

(Arch Surg 113:338-340, 1978)

Author Affiliations
From the Department of Surgery (Dr Geha), Yale University School of Medicine, New Haven, Conn, and Departments of Surgery (Drs Seegers and Kodner) and Medicine (Dr Lefrak), Washington University School of Medicine and the Jewish Hospital of St Louis, St Louis.

Footnotes
Accepted for publication Oct 25, 1977.

Reprint requests to Section of Thoracic and Cardiovascular Surgery, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510 (Dr Geha).