MEDIAN STERNOTOMY AND USE OF A PEDICLED STERNOCLEIDOMASTOID MUSCLE FLAP IN THE MANAGEMENT OF RECURRENT TRACHEOESOPHAGEAL FISTULA

Recurrent tracheoesophageal fistula may complicate primary repair of c ongenital tracheoesophageal fistula. Standard treatment involves repai r via a right lateral thoracotomy and use of adjacent soft tissues to separate the suture lines of the fistulous openings. The authors descr ibe an alternative approach via a median sternotomy, which improves ac cess, reduces the operating time required to identify the recurrent fi stula, and enables the use of a pedicled sternocleidomastoid muscle fl ap to decrease the risk of refistulization. Copyright (C) 1998 by W.B. Saunders Company.