Tracheo-esophageal fistulae are rare condition. It can be congenital or secondary to an underlying cause such as a tracheostomy or an infectious complication.

Patients and methods

This is a retrospective review of all patients operated for an acquired tracheo-esophageal fistula at the Thoracic Surgery Department of Abderrahmane Mami Hospital from 2000 to 2020.

results

Eighteen patients (13 men, 5 women) underwent surgical repair of acquired tracheo-esophageal fistula. The mean age at diagnosis was 37years. The main symptomatology was made up of dyspnea and inhalation. The diagnosis was confirmed by bronchoscopy and esophagoscopy. The first etiology was a previous tracheotomy during a prolonged stay in intensive care unit(n=11), bronchiectasis(n=3), tuberculosis(n=1), foreign body(n=1), esophageal surgery(n=1) and Hodgkin's lymphoma(n=1). For all patients, surgery was decided. They all had suture of the esophagus. Associated tracheal resection-anastomosis was done in 8 cases. Only 5 patients had suture with myoplasty. Patients with bronchiectasis or tuberculosis had an associated pulmonary resection(n=5). Post-operative course was uneventful in 13 patients with removal of the nasogastric tube on day5 and enteral nutrition on day7. Infectious complications occurred in 5 patients and one patient presented a postoperative dysphonia. All patients had satisfactory endoscopic control one month after surgery. For our study, there was no postoperative or long-term mortality.

conclusion

Acquired tracheo-esophageal fistulae can lead to life-threatening complications if not treated swiftly. Complications of mechanical ventilation represent the first etiology. Once tracheo-esophageal fistulae are operated, the results are very satisfactory.