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.
Keywords: Fistula; Oesophagus; Safe-T-tube; Surgery; Trachea; Tracheal open ventilation.
© The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.