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Updated: Oct 8, 2026

Removal of an Intravesical Gellhorn Pessary and Staged Repair of a Residual Large Vesico-Vaginal Fistula
Published on: April 14, 2026
Surgical management of acquired non-malignant tracheo-esophageal fistulas
1Department of Thoracic Surgery, S. Giovanni Battista Hospital, University of Turin, Turin, Italy.
Background:
The aim of this study was to evaluate the results of one-stage surgical management of acquired non-malignant tracheo-esophageal fistulas (TEF).
Methods:
Six consecutive patients, 2 men and 4 women with median age of 65 (range 34-71) years had tracheo-esophageal fistulas resulting from a median of 33 (range 20-86) days of intubation via oro-tracheal or tracheostomy tubes. Median TEF length was 2.6 (range 1.8-3.5) cm and the defect was associated with a tracheal stenosis near or immediately below the stoma in 4 cases (66%). Tracheal resection and anastomosis with primary esophageal closure was carried out in 4 patients; direct closure of the tracheal and esophageal defects with muscle flap interposition was performed in 2 patients: tracheal stoma was left in site because of the high risk of postoperative respiratory insufficiency related to chronic obstructive pulmonary disease.
Results:
All six patients had complete control of the TEF. One perioperative death occurred on day 27 (16%) related to the recurrence of endocranial bleeding. The 5 long-term survivors were routinely submitted to tracheo-bronchoscopic control and only one (20%) revealed granulation tissue at the suture line requiring two consecutive bronchoscopic removals.
Conclusions:
Postintubation tracheoesophageal fistula is usually best treated with one-stage surgical procedure: which preferably consists of tracheal resection and anastomosis and primary esophageal closure.
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