초록접수 현황
| 20F-055 | 구연 발표 |
Surgical treatment outcomes of acquired benign tracheoesophageal fistula: a literature review
¹⁾Do Hyung Kim, M.D., ²⁾Yeong Dae Kim, M.D., ²⁾Hoseok I, M.D., ²⁾Jeong Su Cho, M.D., ²⁾Hyo Yeong Ahn, M.D., ¹⁾Sung Kwang Lee, M.D.
¹⁾ Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Yangsan, Gyeongsangnam-do, Republic of Korea.
²⁾ Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Pusan National University College of Medicine, Gudeok-ro, Seo-Gu, Busan, Republic of Korea
Purpose : Tracheoesophageal fistulas (TEF) are rare and require complex surgical treatment. We analyzed the surgical outcomes of TEF reported in the previous literature and our institute to standardized techniques.
Methods : This retrospective study included 8 patients diagnosed with acquired benign TEF between March 2010 and December 2019. Gastric endoscopy was used to diagnose and measure length of TEF. Determination of surgical method among primary repair or reconstruction was depended on the size of the fistula.
Results : TEF occurred in 7 patients after intubation or a tracheostomy and in 1 patient after esophageal surgery because of conduit necrosis. For tracheal management, 5, 2, and 1 patient underwent tracheal resection and end-to-end anastomosis, primary repair, and division with a stapler, respectively. The median length of tracheal resection was 2.5 cm (range, 1.3–3.4 cm). Six patients underwent primary repair, 1 patient underwent division with a stapler, and 1 patient underwent esophageal diversion treatment. Interposition of the muscle flap was performed in 2 patients. TEF recurred in 1 patient. Stenosis of the esophagus occurred in 1 patient. Dehiscence or granulation occurred in 2 patients. A long-term tracheostomy tube or T-tube was used in 2 patients for >2 months. There were no mortalities within 30 days postoperatively, and all patients were discharged successfully.
Conclusion : Although TEF surgery is complex and challenging, good results can be achieved if surgery is performed by a well-trained surgical team with appropriate medical care. If the standard of surgery is established and a lot of experience is accumulated, better clinical results and be expected.
Methods : This retrospective study included 8 patients diagnosed with acquired benign TEF between March 2010 and December 2019. Gastric endoscopy was used to diagnose and measure length of TEF. Determination of surgical method among primary repair or reconstruction was depended on the size of the fistula.
Results : TEF occurred in 7 patients after intubation or a tracheostomy and in 1 patient after esophageal surgery because of conduit necrosis. For tracheal management, 5, 2, and 1 patient underwent tracheal resection and end-to-end anastomosis, primary repair, and division with a stapler, respectively. The median length of tracheal resection was 2.5 cm (range, 1.3–3.4 cm). Six patients underwent primary repair, 1 patient underwent division with a stapler, and 1 patient underwent esophageal diversion treatment. Interposition of the muscle flap was performed in 2 patients. TEF recurred in 1 patient. Stenosis of the esophagus occurred in 1 patient. Dehiscence or granulation occurred in 2 patients. A long-term tracheostomy tube or T-tube was used in 2 patients for >2 months. There were no mortalities within 30 days postoperatively, and all patients were discharged successfully.
Conclusion : Although TEF surgery is complex and challenging, good results can be achieved if surgery is performed by a well-trained surgical team with appropriate medical care. If the standard of surgery is established and a lot of experience is accumulated, better clinical results and be expected.
책임저자: Do-Hyung Kim
Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Pusan National University College of Medicine, Yangsan, Gyeongsangnam-do, Republic of Korea.
발표자: Sung Kwang Lee, E-mail : drlsk@naver.com