Frontiers in Medicine (Jun 2020)

Large Tracheocutaneous Fistula Successfully Treated With Bronchoscopic Intervention and Flap Grafting: A Case Report and Literature Review

  • He-huan Li,
  • Ning Zhao,
  • Jing-wen Lu,
  • Ru-rong Tang,
  • Chao-nan Liang,
  • Gang Hou

DOI
https://doi.org/10.3389/fmed.2020.00278
Journal volume & issue
Vol. 7

Abstract

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Tracheocutaneous fistula (TCF) is the most common related post-operative complication after tracheotomy. Treatments such as surgery and flap grafting are usually applied to close TCFs. We report a case of a large TCF with an area of ~3.0 cm × 1.0 cm. Here, we describe a relatively convenient approach for the management of a patient with a large TCF. In our treatment strategy, a coverd tracheal stent was used to cover the defect by bronchoscopy, the bronchial defect was closed with a local turnover flap, the structure was reinforced with biodegradable material (RapidSorb Plate 2.0), and then transplantation of a deltopectoral flap was performed. It is worth noting that the patency of the trachea was maintained during the whole surgery course. No recurrence or complications occurred after the 12-month follow-up. The large TCF was successfully treated with bronchoscopic intervention, biodegradable material and flap grafting, and without cartilage grafting.

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