A simple surgical technique for tracheoesophageal fistula closure

Placement of a voice device in a tracheoesophageal fistula provides successful speech rehabilitation after total laryngectomy. However, in the long term, removal of the voice device and permanent closure of the fistula is sometimes necessary. This paper presents and evaluates a simple surgical technique for primary closure of tracheo-esophageal fistulae. We retrospectively review 12 laryngectomees who received this technique of primary closure from 1997 to 2000. In 58% of the patients, permanent fistula closure could be obtained. Six patients (50%) healed primarily; in one patient (8%) the residual fistula opening healed secondarily. Four patients (33%) needed a second surgical procedure, and in one patient (8%) inserting a new speech prosthesis obliterated the residual fistula. Radiotherapy seems to compromise wound healing and therefore may be considered as a contraindication. Complications such as tracheal stenosis, tissue necrosis and pneumonia, etc., did not occur.