Surgical closure of enlarged tracheoesophageal fistula after laryngectomy: A systematic review of techniques

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.

© This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/

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Work Title Surgical closure of enlarged tracheoesophageal fistula after laryngectomy: A systematic review of techniques
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Open Access
Creators
  1. C Lane
  2. Maxwell Wright
  3. Janice Linton
  4. Neerav Goyal
Keyword
  1. Systematic review
  2. Tracheoesophageal fistula
  3. Laryngectomy
  4. Reconstruction
License CC BY-NC-ND 4.0 (Attribution-NonCommercial-NoDerivatives)
Work Type Article
Publisher
  1. American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Publication Date January 2024
Publisher Identifier (DOI)
  1. https://doi.org/10.1016/j.amjoto.2023.104023
Deposited November 08, 2024

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Version 1
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  • Created
  • Added surgical-closure-enlarged-tracheoesophageal-fistula.docx
  • Added Creator C Lane
  • Added Creator Maxwell Wright
  • Added Creator Janice Linton
  • Added Creator Neerav Goyal
  • Published
  • Updated
  • Updated Keyword, Publication Date Show Changes
    Keyword
    • Systematic review , Tracheoesophageal fistula , Laryngectomy , Reconstruction
    Publication Date
    • 2024-01-01
    • 2024-01