A Clinical Study On Direct Closure And Isolation With Cutter Stapler For The Treatment Of Benign Acquired Tracheoesophageal Fistula

ObjectiveTo explore the recent and long-term clinical effects of cutter stapler in the surgical treatment of benign acquired tracheoesophageal fistula(TEF).MethodsRetrospective analyses were performed on patients undergoing TEF incision and separate repair for the treatment of benign acquired TEF;excluding those patients complicated by tracheal and/or esophageal stenosis or tracheal and/or esophageal injury requiring reconstruction,a total of 41 patients were enrolled,who were assigned,based on whether cutter stapler was used for fistula closure,to the conventional group or cutter stapler group.Statistical analyses were performed to compare the two groups for surgery duration,intraoperative blood loss,time to removal of drainage tubes,and length of postoperative hospital stay,and the incidences of suture rupture,recurrent fistula,infection,stenosis,and death were summarized for both groups.ResultsAll the 41 patients completed TEF incision and separate repair successfully.Among the 19 patients in conventional group,4 cases(21.05%)experienced fistula suture rapture,3 cases(15.79%)experienced infection,1 case(5.26%)experienced recurrent fistula,and 1 case(5.26%)was dead postoperatively;among the 22 patients in cutter stapler group,only 1 case(4.55%)patient experienced fistula suture rapture postoperatively,indicating significantly lower incidence of surgical complications in cutter stapler group than in conventional group.In conventional group,the mean surgery duration was(278.9±39.5)min,the intraoperative blood loss was(198.4±102.4)ml,the time to removal of drainage tubes was(12.8 ±6.6)d,and the length of postoperative hospital stay was(19.5±4.9)d;in cutter stapler group,the mean surgery duration was(228.2±37.9)min,the intraoperative blood loss was(118.2±74.6)ml,the time to removal of drainage tubes was(9.5±2.9)d,and the length of postoperative hospital stay was(17.0±2.9)d.Statistical analyses showed statistically significant differences between the two groups in surgery duration and intraoperative blood loss,and no statistically significant difference between the two groups in length of postoperative hospital stay or time to removal of drainage tubes.ConclusionFor the treatment of benign acquired TEF,direct closure and isolation with cutter stapler was significantly superior over conventional TEF incision and separate repair,with more precise for the closure of the fistula,more effective reduced surgical infection,simpler surgical procedures,significantly reduced surgery duration,and less intraoperative blood loss,and was effective for preventing collateral damage as well as short-and long-term postoperative complications.These indicate its positive effects supporting its further application.