A SIMPLE METHOD FOR CLOSURE OF TRACHEOCUTANEOUS FISTULA IN CHILDREN

Objective: To review the results of a simple technique of closure of p ersistent tracheocutaneous fistula (TCF) in children. Design: Retrospe ctive case series. Setting: Tertiary pediatric otolaryngology referral center. Patients: Children (age, <18 years) who underwent repair of T CF from July 1, 1991, to August 31, 1996. Interventions: Surgical clos ure of persistent TCF using multilayered closure of de-epithelialized local tissue. Tracheal dissection was not performed. A thermal hemosta tic scalpel was used in some cases to assist in de-epithelialization a nd provide hemostasis without electrocautery near the airway. Main Out come Measures: Success of closure and number and types of complication s. Results: Nine procedures were performed in 8 children. Seven (88%) of 8 primary procedures were successful, but early recurrent TCF devel oped in 1 patient. Revision surgery using an identical surgical techni que, but maintaining endotracheal intubation for 48 hours, was success ful in this patient. No complications occurred. Conclusions: This proc edure is a simple, reliable method for closure of TCF in children.