[Benign acquired tracheoesophageal fistulas]

Area of Science:

• Thoracic Surgery
• Gastroenterology
• Pulmonology

Background:

• Benign acquired tracheoesophageal fistula (TEF) presents significant morbidity and mortality risks.
• Management of TEF requires careful consideration of patient factors and surgical techniques.

Purpose of the Study:

• To review the hospital's experience with benign acquired TEF over 16 years.
• To analyze demographic, clinical, and therapeutic variables associated with TEF outcomes.
• To identify factors influencing surgical success in TEF treatment.

Main Methods:

• Retrospective review of 18 patients treated for benign acquired TEF.
• Descriptive analysis of patient demographics, clinical presentation, diagnostic methods, and surgical interventions.
• Evaluation of surgical success rates, complications, and recurrence.

Main Results:

• Fifteen of 18 patients underwent surgery with an 80% success rate in respiration, swallowing, and phonation.
• Simple TEF closure required a second operation for tracheal stenosis in 50% of cases.
• Resection and anastomosis for associated tracheal stenosis had a lower reoperation rate (1/11).
• Tracheoscopy and CT scans were effective diagnostic tools.
• Perioperative mortality occurred in 2 cases, and 1 recurrence was linked to ventilation.

Conclusions:

• Successful TEF management hinges on presurgical evaluation of tracheal stenosis, avoiding mechanical ventilation, and meticulous preoperative and postoperative care.
• Resection and anastomosis are recommended for TEF associated with tracheal stenosis.
• Early diagnosis and tailored surgical approaches are crucial for optimal patient outcomes.