Surgical closure of enlarged tracheoesophageal fistula after laryngectomy: A systematic review of techniques.
Publication/Presentation Date
1-1-2024
Abstract
OBJECTIVES: The objectives of the study were (1) systematically review the data on surgical closure of enlarged tracheoesophageal fistula after laryngectomy and (2) to perform a comparison of reconstruction of surgical techniques.
METHODS: Systematic review was performed using PRISMA methodology. Cumulative patient data were compared between patients reconstructed with vascularized tissue (sternocleidomastoid fascia and muscle, pectoralis major, deltopectoral, radial forearm) and those closed primarily (two-layer, three-layer, and tracheal transposition).
RESULTS: Fourteen studies reported outcomes for the reconstruction of tracheoesophageal fistula. Primary closure was used in 98 patients, vascularized flap in 74, and occlusive device in 8. Vascularized flap resulted in successful closure of the fistula in 89 % of cases compared to primary closure in 62 % (p = 0.0003).
CONCLUSION: Systematic review of the literature supports an improved surgical closure rate with vascularized flap interposed between the esophageal and tracheal lumens compared to primary closure.
Volume
45
Issue
1
First Page
104023
Last Page
104023
ISSN
1532-818X
Published In/Presented At
Lane, C., Wright, M., Linton, J., & Goyal, N. (2024). Surgical closure of enlarged tracheoesophageal fistula after laryngectomy: A systematic review of techniques. American journal of otolaryngology, 45(1), 104023. https://doi.org/10.1016/j.amjoto.2023.104023
Disciplines
Medicine and Health Sciences
PubMedID
37659224
Department(s)
Fellows and Residents
Document Type
Article