Surgery for benign tracheoesophageal fistula

Parshin A.V.; Reshetov I.V.; Parshin V.D.; Rusakov M.A.; Mariyko A.V.; Glotov E.M.

doi:https://doi.org/10.17116/hirurgia20260319

Parshin A.V.

National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow, Russia;
Federal Medical Biological Agency of Russia, Moscow, Russia

ORCID: 0000-0003-1804-3386

Reshetov I.V.

Federal Medical Biological Agency of Russia, Moscow, Russia;
Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

ORCID: 0000-0002-3888-8004

Parshin V.D.

National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow, Russia;
Federal Medical Biological Agency of Russia, Moscow, Russia;
Russian Medical Academy for Continuous Professional Education, Moscow, Russia

ORCID: 0000-0002-0104-481X

Rusakov M.A.

National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow, Russia

ORCID: 0000-0002-0796-2232

Mariyko A.V.

National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow, Russia

ORCID: 0000-0002-1968-0435

Glotov E.M.

Russian Medical Academy for Continuous Professional Education, Moscow, Russia

ORCID: 0000-0002-6900-4881

Surgery for benign tracheoesophageal fistula

Authors:

Parshin A.V., Reshetov I.V., Parshin V.D., Rusakov M.A., Mariyko A.V., Glotov E.M.

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Journal: Pirogov Russian Journal of Surgery. 2026;(3): 9‑17

DOI: 10.17116/hirurgia20260319

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To cite this article:

Parshin AV, Reshetov IV, Parshin VD, Rusakov MA, Mariyko AV, Glotov EM. Surgery for benign tracheoesophageal fistula. Pirogov Russian Journal of Surgery. 2026;(3):9‑17. (In Russ.)
https://doi.org/10.17116/hirurgia20260319

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To improve the outcomes in patients with tracheoesophageal fistula (TEF), including those with concurrent tracheal stenosis and recurrent fistula, using various modern surgical interventions.

MATERIAL AND METHODS

There were 115 patients with TEF in 2004—2023. Annual number of patients doubled when comparing with the period from 1963 to 2002. In 85.4% of cases, TEF was caused by iatrogenic injury of trachea and esophagus after mechanical ventilation or tracheostomy: 56 patients (48.7%) had fistulas after tracheostomy, 42 (36.7%) ones — after intubation. Concurrent TEF and tracheal stenosis were diagnosed in 68 (59.1%) patients. Fistula was more frequently located in the upper segment of the airway (83 (72.2%) patients) and in the larynx (13%). Among 115 patients with TEF, 24 (20.9%) ones previously underwent unsuccessful fistula repair in other clinics. Only 4 (16.7%) ones did not have tracheal stenosis. Twenty-one (30.9%) out of 68 patients with concomitant tracheal stenosis had stridor and underwent emergency endoscopic tracheal recanalization. Balloon dilation was used in only 6 patients, while dilation was used in other cases. Extent of surgical treatment depended on location and size of fistula, as well as its combination with tracheal stenosis. Airway restoration via tracheal resection followed by anastomosis was performed in 29 out of 68 patients with comorbidity. If circumferential tracheal resection was contraindicated, tracheoplasty with T-tube was performed (19 out of 68 patients).

RESULTS

There was no postoperative mortality. Unfavorable postoperative course was diagnosed in 31 (26.9%) patients that comprised 19.3% according to the number of surgeries. Combination of TEF and tracheal stenosis exacerbated the situation. Among 68 similar patients, 21 (30.1%) ones experienced postoperative complications.

CONCLUSION

The problem of surgical treatment for TEF remains relevant. Basic diagnostic and surgical principles significantly reduced the incidence of postoperative complications and mortality. However, this is less true for TEF with simultaneous tracheal stenosis. These patients constitute the most complex and severe group. Simultaneous surgeries (TEF closure and correction of stenosis via circular tracheal resection with anastomosis) are preferable. In case of TEF recurrence, redo surgeries are possible with favorable results.

Keywords:

tracheoesophageal fistula surgery

surgery for cicatricial tracheal stenosis

recurrent tracheoesophageal fistula and tracheal stenosis

treatment outcomes

Authors:

Parshin A.V.

National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow, Russia;
Federal Medical Biological Agency of Russia, Moscow, Russia

ORCID: 0000-0003-1804-3386

Reshetov I.V.

Federal Medical Biological Agency of Russia, Moscow, Russia;
Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

ORCID: 0000-0002-3888-8004

Parshin V.D.

ORCID: 0000-0002-0104-481X

Rusakov M.A.

National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow, Russia

ORCID: 0000-0002-0796-2232

Mariyko A.V.

National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow, Russia

ORCID: 0000-0002-1968-0435

Glotov E.M.

Russian Medical Academy for Continuous Professional Education, Moscow, Russia

ORCID: 0000-0002-6900-4881

Received:

18.03.2025

Accepted:

20.04.2025

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