scholarly journals Tracheoesophageal fistula due to a displaced external tracheal stent repaired using a local flap composed of intercostal muscle and rib periosteum

2019 ◽  
Vol 42 ◽  
pp. 48-50
Author(s):  
Kiichiro Yaguchi ◽  
Masahiko Noguchi ◽  
Yoshichika Yasunaga ◽  
Yuki Hoshino ◽  
Shunsuke Yuzuriha
Keyword(s):  
Tracheoesophageal Fistula ◽  
Local Flap ◽  
Intercostal Muscle ◽  
Tracheal Stent

Silicone Airway Stent for Treating Benign Tracheoesophageal Fistula

2005 ◽  
Vol 13 (2) ◽  
pp. 178-180 ◽  
Author(s):  
Yun-Hen Liu ◽  
Po-Jen Ko ◽  
Yi-Cheng Wu ◽  
Hui-Ping Liu ◽  
Ying-Huang Tsai
Keyword(s):  
Tracheoesophageal Fistula ◽  
Ventilatory Support ◽  
Airway Patency ◽  
Tracheal Stent ◽  
Airway Stent

We used a silicone tracheal stent successfully to seal a huge benign tracheoesophageal fistula and restore airway patency after treatment with double metallic stenting of the trachea and esophagus failed. The patient was weaned from the ventilator 16 days after the procedure and after 7 months of ventilatory support.

scholarly journals Omental Flap Provides Definitive Management for Pediatric Patient With Multiple Tracheoesophageal Fistula Recurrences

2020 ◽  
Vol 86 (11) ◽  
pp. 1553-1555
Author(s):  
Sabrina Mangat ◽  
Benjamin E. Haithcock ◽  
Sean E. Mclean
Keyword(s):  
Pediatric Patient ◽  
Esophageal Atresia ◽  
Reconstructive Surgery ◽  
Tracheoesophageal Fistula ◽  
Female Infant ◽  
Omental Flap ◽  
Intercostal Muscle ◽  
The Third ◽  
Operative Repair ◽  
Definitive Management

A term female infant with tracheoesophageal fistula (TEF) and esophageal atresia (EA) underwent primary operative repair that failed with 3 TEF recurrences, which all presented with feeding and respiratory issues. Recurrences were managed with reoperation and an interpositional flap of pleura and a flap of intercostal muscle on 2 separate occasions. The third recurrence was managed with complete dissection of the esophagus prior to the division of the fistula and the interposition of an omental flap between the esophageal and tracheal repair. We present the use of a viable omental flap and complete esophageal mobilization to prevent subsequent TEF recurrences and avoid the additional morbidity of reconstructive surgery.

Fetoscopic balloon dilation and stent placement of congenital high airway obstruction syndrome leading to successful Caesarian delivery

2022 ◽  
Author(s):  
Alice King ◽  
Joshua R. Bedwell ◽  
Deepak K. Mehta ◽  
Gary E. Stapleton ◽  
Henri Justino ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Stent Placement ◽  
Maternal Morbidity ◽  
Tracheoesophageal Fistula ◽  
Balloon Dilation ◽  
Laryngeal Stenosis ◽  
Tracheal Stent ◽  
Neonatal Hypoxia ◽  
Exit Procedure

Introduction: Without fetal or perinatal intervention, congenital high airway obstruction syndrome (CHAOS) is a fatal anomaly. The ex utero intrapartum treatment (EXIT) procedure has been used to secure the fetal airway and minimize neonatal hypoxia, but is associated with increased maternal morbidity. Case Presentation: A 16-year-old woman (gravida 1, para 0) was referred to our hospital at 31 weeks gestation with fetal anomalies, including echogenic lungs, tracheobronchial dilation and flattened diaphragms. At 32 weeks, fetoscopic evaluation identified laryngeal stenosis, which was subsequently treated with balloon dilation and stent placement. The patient developed symptomatic and regular preterm contractions at post-operative day 7 with persistent sonographic signs of CHAOS, which prompted a repeat fetoscopy with confirmation of a patent fetal airway followed by Cesarean delivery under neuraxial anesthesia. Attempts to intubate through the tracheal stent were limited and resulted in removal of the stent. A neonatal airway was successfully established with rigid bronchoscopy. Direct laryngoscopy and bronchoscopy confirmed laryngeal stenosis with a small tracheoesophageal fistula immediately inferior to the laryngeal stenosis and significant tracheomalacia. A tracheostomy was then immediately performed for anticipated long term airway and pulmonary management. The procedures were well tolerated by both mom and baby. The baby demonstrated spontaneous healing of the tracheoesophageal fistula by day of life 7 with discharge home with ventilator support at three months of life. Conclusion: Use of repeated fetoscopy in order to relieve fetal upper airway obstruction offers the potential to minimize neonatal hypoxia, while concurrently decreasing maternal morbidity by avoiding an EXIT procedure. Use of the tracheal stent in CHAOS requires further investigation. The long-term reconstruction and respiratory support of children with CHAOS remain challenging

scholarly journals Rapid Progression of Tracheoesophageal Fistula Caused by Immunotherapy Administered after Tracheal Stent Placement

2019 ◽  
Vol 4 (2) ◽  
pp. 1-5 ◽  
Author(s):  
Shinjiro Mizuguchi ◽  
Makoto Takahama ◽  
Ryu Nakajima ◽  
Hidetoshi Inoue ◽  
Ryuichi Ito ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Lymph Node ◽  
Tracheoesophageal Fistula ◽  
Metastatic Lymph Node ◽  
Rapid Development ◽  
Advanced Lung Cancer ◽  
Rapid Progression ◽  
Tracheal Stent ◽  
Line Therapy

Development of a tracheoesophageal fistula (TEF) is a serious complication of treatment for esophageal or lung cancer, especially following radiation therapy. However, development of a TEF as a complication of chemotherapy or tracheal stenting after surgical debulking is quite uncommon. We herein report a rare case involving a patient with advanced adenocarcinoma invading the mediastinum who rapidly developed a TEF after placement of a tracheal stent and administration of nivolumab immunotherapy. A 55-year-old heavy ex-smoker was diagnosed with lung adenocarcinoma with mediastinal invasion. Nine months after first-line therapy (chemotherapy and radiation therapy), he underwent treatment with nivolumab (3 mg/kg) as fourth-line therapy. Two weeks after the first dose, he underwent mechanical debulking of the tumor with tracheal stenting because of the rapid development of paraesophageal lymph node swelling and severe tracheal stenosis. He received a second dose of nivolumab 2 weeks later; however, imaging studies 12 days after this second dose revealed a huge fistula between the upper trachea and esophagus through a metastatic lymph node. Neither an additional stent nor replacement of the stent was considered because of the fistula site expansion and suffocation risk. Despite further treatment, the patient died of his primary disease 2 months later. Our findings will be of great interest to the readers, especially those involved in the clinical treatment of patients with advanced lung cancer treated by immunotherapy. The knowledge of potentially devastating TEF formation in the presence of transmural tracheal metastasis/invasion will allow clinicians to provide the best possible care for their patients.

scholarly journals Double hitch stitch is a novel technique for fixation of tracheal stent in a case of tracheoesophageal fistula: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Sameer A. Arbat ◽  
Parimal S. Deshpande ◽  
Sweta R. Chourasia
Keyword(s):  
Tracheoesophageal Fistula ◽  
Subcutaneous Tissue ◽  
Stent Migration ◽  
Esophageal Stent ◽  
Metallic Stent ◽  
Carcinoma Of The Esophagus ◽  
Tracheal Stent ◽  
Expandable Metallic Stent ◽  
Life Threatening

Abstract Background Caudal tracheal stent migration can be potentially life threatening by causing distal luminal obstruction. We present a rare double hitch stitch procedure (for prevention of migration of tracheal stent), which is an external fixation technique in a case of tracheoesophageal fistula with tracheal and esophageal self-expandable metallic stent (SEMS). Case presentation A 50-year-old male patient who presented with cough and dyspnea was a known case of carcinoma of the esophagus with esophageal stent in situ. Computed tomography (CT) scan showed tracheoesophageal fistula with esophageal stent (esophageal SEMS) migrating into the trachea. Tracheal stenting was done with SEMS. Patient was followed up after 1 month with recurrent complaints of cough on deglutition. On follow-up bronchoscopy, migration of stent was observed. A rare procedure of double hitch stitch was performed with fixation of the tracheal stent (tracheal SEMS) using a percutaneous anchoring stitch, embedded in the subcutaneous tissue. Follow-up bronchoscopy after 1 month of the procedure showed no migration of stent. Conclusion For the treatment of large tracheoesophageal fistula, stenting of both the trachea and the esophagus along with the double hitch stitch proved to be lifesaving. Stent migration prevention using “double hitch-stitch” is simple, safe, and successful, without any complications.

scholarly journals Homograft Treatment for Infected Frozen Elephant Trunk Prosthesis

2020 ◽  
Vol 23 (6) ◽  
pp. E786-E788
Author(s):  
Petar Risteski ◽  
Razan Salem ◽  
Thomas Walther ◽  
Johanna Kessel ◽  
Wolf Otto Bechstein
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Tracheoesophageal Fistula ◽  
Muscle Flap ◽  
Total Arch Replacement ◽  
Intercostal Muscle ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Descending Aorta ◽  
Intercostal Muscle Flap

A 46-year-old male received total arch replacement with frozen elephant trunk for acute non-A/non-B aortic dissection. Two months later, he underwent emergency reoperation for contained rupture of the left common carotid ostium at its insertion on the aortic arch. Three months after the reoperation, he developed tracheoesophageal fistula and infection of the prosthesis in the region of the aortic arch and the proximal descending aorta. Second reoperation was performed with replacement of the aorta with a composite of three aortic homografts, and the fistula was permanently closed with a direct suture and intercostal muscle flap

scholarly journals Tracheoesophageal Fistula due to a Damaged Tracheal Stent

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Masahiro Kimura ◽  
Yoshiyuki Kuwabara ◽  
Hideyuki Ishiguro ◽  
Tatsuya Tanaka ◽  
Hiromitsu Takeyama
Keyword(s):  
Tracheal Stenosis ◽  
Tracheoesophageal Fistula ◽  
Benign Disease ◽  
Smoke Inhalation ◽  
Metallic Stent ◽  
Tracheal Stent ◽  
History Of ◽  
Mediastinal Tracheostomy

We describe the management of a tracheoesophageal fistula due to a damaged tracheal stent, which was first inserted to treat tracheal stenosis. A 29-year-old woman with a history of treated epilepsy had a seizure and suffered from smoke inhalation during a fire. Breathing difficulties appeared and gradually worsened; consultation was obtained two years afterward. After undergoing a thorough examination, the patient was diagnosed with tracheal strangulation. A noncovered, metallic stent was inserted. When the patient was 37 years old, she was admitted to our hospital for the treatment of a tracheoesophageal fistula. We diagnosed it as a tracheoesophageal fistula due to the collapse of the damaged tracheal stent toward the esophageal side, and we decided to perform a mediastinal tracheostomy. Granulation may be formed in the circumference of a stent that has been present for a prolonged period, and removal of the stent may become difficult. This case suggests that insertion of a noncovered, metallic stent is contraindicated for a benign disease.

scholarly journals Tracheoesophageal fistula managed with tracheal stent through flexible bronchoscopy without fluoroscopy

2016 ◽  
Vol 65 (4) ◽  
Author(s):  
G. Stratakos ◽  
C. Zisis ◽  
I. Bellenis ◽  
V. Filaditaki ◽  
A. Liapikou ◽  
...  
Keyword(s):  
Clinical Improvement ◽  
Stent Placement ◽  
Poor Prognosis ◽  
Tracheoesophageal Fistula ◽  
Therapeutic Option ◽  
Rigid Bronchoscopy ◽  
Flexible Bronchoscopy ◽  
Septic Complication ◽  
Tracheal Stent ◽  
Esophageal Stenting

Inoperable malignant tracheoesophageal fistula (TEF) is characterised by an extremely poor prognosis. Tracheal or double (tracheal-esophageal) stenting through rigid bronchoscopy has been suggested as a valuable therapeutic option. We report on a patient with a large TEF successfully sealed by deployment of a self-expandable stent through flexible bronchoscopy (FB) without fluoroscopy. Dramatically improved health status permitted him to undergo radiation, attaining further clinical improvement. Four months after stent placement no sequelae were observed. During the fifth month a new fistula developed distally to the stent finally leading to death from septic complication. Palliative management of inoperable malignant TEF by tracheal stent placement through FB without fluoroscopy, is feasible, safe and rewarding leading to important clinical improvement.

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