[Surgical treatment of non-malignant tracheoesophageal fistula]

Tracheoesophageal fistula is a complication of endotracheal canulas with pressure balloon during mechanical ventilation, for which treatment is surgical closure. There are approximately 80 reported cases in the world literature. Here we report our experience at the National Institute of Respiratory Diseases of Mexico. We performed surgical treatment of 7 patients (4 males, 3 females, 17 to 65 years of age) with tracheoesophageal fistula from 1991 to 1995, referred from other hospitals. Six had a history of prolonged orotracheal intubation, and the seventh had a traumatic lesion of the neck. Preoperatory management varied from 1 to 8 weeks, with treatment of malnutrition and infections. Esophagus was sutured with polyglactin 000 in two layers, the inner with interrupted, and the superficial with continuous sutures. The area was covered with a muscle strap. In six patients, simple suture of trachea was performed. In the seventh, due to an extensive tracheal defect, we decided to use a second muscle strap to occlude it. Six patients have had a follow up of 15 months to 5 years with satisfactory evolution. One patient died due to abdominal sepsis. We conclude that this technique provides a good prognosis for this disorder.