TY - JOUR
T1 - Giant acquired tracheoesophageal fistulas
T2 - Strategy for successful management
AU - Freeman, M. Sean
AU - Livingstone, Alan S.
AU - Goodwin, E. Jarrard
PY - 1986/1/1
Y1 - 1986/1/1
N2 - Giant tracheoesophageal fistulas (TEF) present a significant management problem for the head and neck surgeon. Chronic aspiration and sepsis are associated complications that occur in these patients, who are frequently already debilitated from pre-existing medical calamities. The combination results in prolonged morbidity and frequent mortality. Recently, we have managed two patients with this difficult problem. The first patient was managed using conventional methods well described in the literature with an unsuccessful outcome. The second was managed differently using a two-stage approach. The esophageal stream was first excluded from the respiratory system via a surgical approach, which to the best of our knowledge has not been previously described in the literature. After a period of convalescence, the patient's alimentary tract is reconstituted with a gastric pull-up, reversed gastric tube, or colon interposition. We propose this as an alternative method of management for TEF.
AB - Giant tracheoesophageal fistulas (TEF) present a significant management problem for the head and neck surgeon. Chronic aspiration and sepsis are associated complications that occur in these patients, who are frequently already debilitated from pre-existing medical calamities. The combination results in prolonged morbidity and frequent mortality. Recently, we have managed two patients with this difficult problem. The first patient was managed using conventional methods well described in the literature with an unsuccessful outcome. The second was managed differently using a two-stage approach. The esophageal stream was first excluded from the respiratory system via a surgical approach, which to the best of our knowledge has not been previously described in the literature. After a period of convalescence, the patient's alimentary tract is reconstituted with a gastric pull-up, reversed gastric tube, or colon interposition. We propose this as an alternative method of management for TEF.
UR - http://www.scopus.com/inward/record.url?scp=0022745672&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0022745672&partnerID=8YFLogxK
U2 - 10.1002/hed.2890080611
DO - 10.1002/hed.2890080611
M3 - Article
C2 - 3721889
AN - SCOPUS:0022745672
VL - 8
SP - 463
EP - 465
JO - Head and Neck
JF - Head and Neck
SN - 1043-3074
IS - 6
ER -