title: The surgical repair of benign tracheo-oesophageal/pharyngeal fistula in patients on mechanical ventilation for severe neurological injuries†.
abstract: Acquired benign tracheo-oesophageal or pharyngeal fistulas (TO/PF) in neurological patients who cannot be weaned from mechanical ventilation represent a highly demanding clinical problem. We report on 3 patients on intermittent or continuous mechanical ventilation who successfully underwent tracheal resection and direct repair of the digestive fistula. Postoperative mechanical ventilation was provided through a modified silicone Safe-T-Tube, with which the cranial branch can be occluded with an internal inflatable balloon, inserted through tracheostomy performed at or below the level of the cricoid-tracheal suture line. Since the T prosthesis does not have an external cuff in the distal branch, a trans-tracheal open ventilation (TOV) technique was adopted. All patients, after a period that ranged from 21 h to 38 days from surgery, were restored to spontaneous breath; tracheal and oesophageal sutures healed normally.
authors: U.O. Thoracic Surgery at the Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy.
authors: Niccolò
authors: N
authors: Daddi
authors: U.O. Thoracic Surgery at the Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy.
authors: Valentina
authors: V
authors: Tassi
authors: Intensive Care Unit, Montecatone Rehabilitation Hospital, Imola, Italy.
authors: Gian Piero
authors: GP
authors: Belloni
authors: U.O. Thoracic Surgery at the Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy Division of Thoracic Surgery, GMV Care and Research, Lugo, Italy sandro.mattioli@unibo.it.
authors: Sandro
authors: S
authors: Mattioli
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D011782:Quadriplegia / Q000628:therapy; D012121:Respiration, Artificial / Q000295:instrumentation*; D014138:Tracheoesophageal Fistula / Q000601:surgery*
keywords: Fistula; Oesophagus; Safe-T-tube; Surgery; Trachea; Tracheal open ventilation