Laser ablation of granulation tissue at the tracheoesophageal puncture site.
BACKGROUND
Tracheoesophageal fistula speech may be complicated by granulation tissue around the puncture site. Treatment includes antibiotics, antifungals, chemical or electrocautery, and surgical excision of the granulation tissue. Chemical cautery generally requires repeated treatment sessions.


METHODS
We report our technique and results of CO(2) laser ablation of granulation tissue at the tracheoesophageal puncture site performed as an outpatient office procedure.


RESULTS
Seven of 9 patients (78%) were cured with a single treatment. The prosthesis was replaced immediately after laser ablation of granulation tissue. Of the remaining 2 patients, 1 had a recurrence a year later, requiring repeated laser. The second patient had a large mass requiring 4 laser ablations. There were no complications.


CONCLUSIONS
CO(2) laser has the following advantages compared with other methods of treating stomal granulation tissue: office procedure; 78% cured with single treatment; and the extent of tissue necrosis is predictable.
Fagan
J J
JJ
Department of Otolaryngology, University of Cape Town School of Medicine, Groote Schuur Hospital, Observatory, Cape Town, South Africa.
Myers
E N
EN
D000368:Aged; D000556:Ambulatory Surgical Procedures; D002245:Carbon Dioxide / Q000627:therapeutic use; D006097:Granulation Tissue / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation; D011677:Punctures / Q000009:adverse effects*; D013072:Speech, Esophageal
D002245:Carbon Dioxide