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Journal of Cardio-Thoracic Medicine
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Daneshvar Kakhki, A., Sheikhi, K., Saghebi, S., Pejhan, S., Sadegh Beigee, F., Shadmehr, M., Karimi, H., Abbasidezfouli, A. (2017). Post-Intubation Tracheoesophageal Fistula; A Nine-Year Experience. Journal of Cardio-Thoracic Medicine, 5(3), 177-180. doi: 10.22038/jctm.2017.24003.1133
Abolghasem Daneshvar Kakhki; Kambiz Sheikhi; Seyed Reza Saghebi; Saviz Pejhan; Farahnaz Sadegh Beigee; Mohammad Behgam Shadmehr; Hasti Karimi; Azizollah Abbasidezfouli. "Post-Intubation Tracheoesophageal Fistula; A Nine-Year Experience". Journal of Cardio-Thoracic Medicine, 5, 3, 2017, 177-180. doi: 10.22038/jctm.2017.24003.1133
Daneshvar Kakhki, A., Sheikhi, K., Saghebi, S., Pejhan, S., Sadegh Beigee, F., Shadmehr, M., Karimi, H., Abbasidezfouli, A. (2017). 'Post-Intubation Tracheoesophageal Fistula; A Nine-Year Experience', Journal of Cardio-Thoracic Medicine, 5(3), pp. 177-180. doi: 10.22038/jctm.2017.24003.1133
Daneshvar Kakhki, A., Sheikhi, K., Saghebi, S., Pejhan, S., Sadegh Beigee, F., Shadmehr, M., Karimi, H., Abbasidezfouli, A. Post-Intubation Tracheoesophageal Fistula; A Nine-Year Experience. Journal of Cardio-Thoracic Medicine, 2017; 5(3): 177-180. doi: 10.22038/jctm.2017.24003.1133

Post-Intubation Tracheoesophageal Fistula; A Nine-Year Experience

Article 1, Volume 5, Issue 3, Summer 2017, Page 177-180  XML PDF (245 K)
Document Type: Original Article
DOI: 10.22038/jctm.2017.24003.1133
Authors
Abolghasem Daneshvar Kakhki1; Kambiz Sheikhi1; Seyed Reza Saghebi 2; Saviz Pejhan2; Farahnaz Sadegh Beigee1; Mohammad Behgam Shadmehr2; Hasti Karimi1; Azizollah Abbasidezfouli3
1General thoracic surgeon, Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Massih Daneshvari Hospital, Tehran, Iran
2General thoracic surgeon, Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Massih Daneshvari Hospital, Tehran, Iran
3General practitioner, Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Massih Daneshvari Hospital, Tehran, Iran
Abstract
Introduction: Tracheoesophageal fistula (TEF) is a rare condition, which could be life-threatening if diagnosed late or mismanaged. Post-intubation TEF is the most common form of acquired, non-malignant TEF and is usually associated with tracheal stenosis, which makes the treatment more challenging. Here, we present our experience of managing 21 patients with post-intubation TEF.  
Materials & Methods: Twenty one patients including seven women and fourteen men with mean age of 38.05 years, who had post-intubation TEF were managed in our center (Massih Daneshvari Hospital, Tehran, Iran) during 2004-2013. None of the patients were operated before weaning from mechanical ventilation. Single division and closure of the fistula was performed in one patient who did not have accompanying tracheal stenosis. One-stage surgical repair including tracheal resection, anastomosis, primary closure of the esophageal defect, and muscle flap Interposition was the main treatment method in all other cases. Patients were followed up for at least two years.
Results: Excellent and good results achieved in 85.7% of our patients. Major complications including permanent vocal cord paralysis and recurrence of tracheal stenosis necessitating T-tube insertion occurred in two patients (9.5%). Severe cachexia and sepsis secondary to sputum retention resulted in one mortality (4.8%).
Conclusion: Surgery might provide the best treatment results along with low mortality and morbidity rates in post-intubation TEFs if performed within the proper time.
Keywords
fistula; Post-intubation; TEF; Tracheal resection; Tracheal stenosis
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