Benign tracheoesophageal fistula: results of surgical therapy

Acquired fistulas between the trachea and the esophagus (TEFs) are unusual, serious and still challenging clinical entities. Between 1980 and 1997, 31 patients with acquired benign TEF were evaluated and treated in our depart ment, The definitive treatment was undertaken when patients were weaned fro m the ventilator. Dissection of the fistula and closure of the tracheal and esophageal defect was performed in 26 patients. Esophagogastroplasty plus closure of the tracheal defect and omental interposition was performed in t wo patients. Tracheal resection and reconstruction plus of the sternocleido mastoid muscle interposition was carried out in one patient with circumfere ntial tracheal damage. In two patients, no surgical treatment was carried o ut. One patient died after surgical treatment. In 23 patients, long-term fo llow-up-was excellent, with normal post-operative function of both the esop hagus and the airway. Two failures of treatment occurred which required def initive tracheostomy plus T-tube. Management of TEFs can be safely carried out after weaning patients from the ventilator.