Minimally invasive management of tracheoesophageal fistula with T-tube.

Christopher M. Tran, MD Louisiana State University Health Sciences Center – New Orleans Email: [email protected] Website: www.lsuhsc.edu Phone: 504.568.4785 Contact 1. Altorjay, A, Mucs, M, Rull, M, et al. Recurrent, nonmalignant tracheoesophageal fistulas and the need for surgical improvisation. Annals of Thoracic Surgery 2010; 89: 1789-1796. 2. Baisi, A, Bonavina, L, Narne, S, Peracchia, A. Benign tracheoesophageal fistulas: results of surgical therapy. Dis Esophagus 1999; 12: 209-211. 3. Blackmon, SH, Santora, R, Schwarz, P, Barroso, A, Dunkin, BJ. Utility of removable esophageal covered self-expanding metal stents for leak and fistula management. Annals of Thoracic Surgery 2010; 89: 931-936. 4. Camargo, JJ, Machuca, TN, Camargo, SM, Lobato, VF, Medina, CR. Surgical treatment of benign tracheoesophageal fistulas with tracheal resection and oesophageal primary closure: is the muscle flap really necessary? Eur J Cardiothoracic Surgery 2010; 37: 576-580. 5. Eleftheriadis, E, Kotzampassi, K. Temporary stenting of acquired benign tracheoesophageal fistulas in critically ill ventilated patients. Surg Endosc 2005; 19: 811-815. 6. Muniappan, A, Wain, JC, Wright, CD, Donahue, DM, Gaissert, H, Lanuti, M, Mathisen, DJ. Surgical Treatment of Nonmalignant Tracheoesophageal Fistula: A Thirty-Five Year Experience. Annals of Thoracic Surgery 2013; 95: 1141-1146. 7. Mathisen, DJ, Grillo, HC, Wain, JC, Hilgenberg, AD. Management of acquired nonmalignant tracheoesophageal fistula. Annals of Thoracic Surgery 1991; 52: 759-765. 8. Shen, KR, Allen, MS, Cassivi, SD et al. Surgical management of acquired nonmalignant tracheoesophageal and bronchoesophageal fistulae. Annals of Thoracic Surgery 2010; 90: 914-918. 9. Zakaluzny, SA, Lane, JD, and Mair, EA. Complications of tracheobronchial airway stents. Otolaryngology Head and Neck Surgery 2003; 128 (4): 478-88. References OBJECTIVES: • Describe a minimally-invasive technique for management of tracheo-esophageal fistulae (TEF) • Analyze outcomes of TEF management with T-tube METHODS: • Retrospective case series at an academic practice in a regional referral center. • 2 patients with TEF who were not candidates for open surgical repair were successfully managed with a Montgomery T-tube (MTT) • Outcome measures included resumption of oral diet, need for further procedures, and fistula size. RESULTS: • Both patients had T-tubes sized to stent the fistula and maintain airway without an esophageal stent. • Fistulae were successfully controlled in all patients with full resumption of oral intake and maintenance of voice. • There was no stent migration or fistula enlargement. • No patients had closure of fistula. CONCLUSION: • MTT stenting is a safe and minimally invasive way to manage TEF in patients who are not candidates for open repair. Abstract