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Eur J Cardiothorac Surg 2000;18:363-365
© 2000 Elsevier Science NL

Case report

Non-malignant tracheo-gastric fistula following esophagectomy for cancer

^a First Department of Surgery, University Medical School of Pécs, Ifjúság u. 13, H-7624 Pécs, Hungary
^b Department of Cardiothoracic Surgery, Bristol Royal Infirmary, Bristol BS2 8HW, UK

Received 18 February 2000; received in revised form 18 May 2000; accepted 21 June 2000.

Corresponding author. Tel./fax.: +36-72-324-083
e-mail: kkalmar{at}iseb.pote.hu

Two cases of neoesophago-tracheal fistula are described. After esophagectomy for cancer a fistula developed between the trachea and the pulled-up stomach probably because of the ischaemic effect of the tracheostomy tube. At single stage repairs, the fistulae were divided and the gastric defects were closed directly. In one case, tracheal resection and anastomosis was necessary. The defect on the membranous trachea in both cases was patched with an autologous fascia lata graft. A left pectoralis major muscle flap was interposed between the suture lines to prevent recurrence of the fistula. Treatment of this potentially life-threatening and rare condition yielded excellent results.

Key Words: Tracheal surgery • Tracheo-gastric fistula • Complications of esophagectomy