[Tracheal stents for esophagotracheal fistula in laryngectomy patients. Safe fixation to the tracheostoma].
BACKGROUND
Postradiotherapy or malignant esophagotracheal fistulas still represent a dilemma. In the absence of surgical options attempts are made to close the fistula endoscopically by means of esophageal and/or tracheal stents. Tracheal stent placement in laryngectomy patients with terminal stomas is particularly problematic due to the risk of stent dislocation during cannula replacement


METHODS
Six laryngectomy patients with high esophagotracheal fistulas were each fitted with a coated Ultraflex stent (Boston Scientific, Watertown/MA, US). Following skin undermining, the stents were fixed to the tracheostoma with interrupted sutures and the skin flaps attached to the stent with a second row of sutures.


RESULTS
Fistulas could be completely closed in all patients and there were no cases of stent dislocation. Cannula replacement was unproblematic.


CONCLUSIONS
Suture fixation of tracheal stents is a viable procedure even for patients with esophagotracheal fistulas and terminal tracheostomy following laryngectomy.
Spelsberg
F W
FW
Chirurgische Klinik und Poliklinik, Campus Grosshadern, Universität München, Marchioninistrasse 15, 81377, München. fritz.spelsberg@med.uni-muenchen.de
Wollenberg
B
B
Weidenhagen
R
R
Lang
R A
RA
Winter
H
H
Jauch
K-W
KW
Hüttl
T P
TP
D019544:Equipment Failure Analysis; D006801:Humans; D007825:Laryngectomy / Q000295:instrumentation*; D011474:Prosthesis Design; D015607:Stents; D014132:Trachea / Q000601:surgery*; D014138:Tracheoesophageal Fistula / Q000601:surgery*; D014139:Tracheostomy / Q000295:instrumentation*; D016896:Treatment Outcome