The surgical approach of late-onset tracheoesophageal fistula in a tracheostomized COVID-19 patient

Submitted: November 22, 2022
Accepted: December 16, 2022
Published: February 7, 2023
Abstract Views: 660
PDF: 178
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In the COVID-19 era the tracheal complications due to prolonged mechanical ventilation have significantly increased. Acquired tracheoesophageal fistula is one of those in ventilated COVID-19 patients. Thus, the knowledge of their management in such fragile patient is crucial. We report a case of tracheoesophageal fistula in a 56-year-old female under prolonged mechanical ventilation for COVID-19 bilateral pneumonia and discuss its management. A surgical approach was proposed. By a collar-shaped transverse cervicotomic access, we transected the trachea at level of fistula en-bloc with the tracheostoma. The esophageal lesion was longitudinally repaired in two-layers. Protective left strap muscle was sandwiched between esophagus and trachea. The tracheal end-to-end anastomosis was completed without a re-tracheostoma. Even if surgical approach of tracheoesophageal fistula in COVID-19 patients has not been tested before, surgery remains the treatment of choice according to the multidisciplinary board.



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How to Cite

Rotolo, Nicola, Maria Cattoni, Silvia De Maio, Luca Filipponi, Pau Mateo-Ramos, and Andrea Imperatori. 2023. “The Surgical Approach of Late-Onset Tracheoesophageal Fistula in a Tracheostomized COVID-19 Patient”. Monaldi Archives for Chest Disease 93 (4).