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Abstract Tracheo-esophageal fistula is defined as pathological communication between trachea and esophagus. It is a life threatening disease and surgical management is difficult, challenging and complex. The etiology often primary or secondary to pathological disease such as: malignancy, direct or blunt trauma, prolonged intubation. In this study will focus on secondary non-malignant trachea-esophageal fistula. Despite the global use of endotracheal tube with high volume low pressure cuffs, prolonged intubation is a common cause of 2ry TEF. Tracheal stenosis and TEF can occur simultaneously following prolonged intubation where TEF occur at the level of the cuff usually between upper and middle third of trachea and tracheal stenosis above it. This study aims to evaluate the results of surgical treatment of trachea-esophageal fistula (TEF) associated with or without tracheal stenosis (TS). This study is a retrospective cohort study was conducted on all cases that underwent surgery for repair of TEF at Ain Shams university hospital in the period from 1st of January 2018 till 30th of September 2023. The outcome of surgical closure of tracheoesophageal fistula was evaluated by complete weaning from mechanical ventilation with complete restoration of airway function and GIT function. In our study extubation was performed on table in 22 cases (84.6%), on 3rd day in 1 case (3.8%), while a T tube was inserted intraoperatively in 2 cases (7.7%) and tracheostomy was planned intraoperatively in 1 case (3.8%) due to observed tension on the anastomosis. Postoperative complications were reported in 5 cases (19.2%) as anastomosis dehiscence in 2 cases (7.7%) which required exploration, repair, and tracheostomy, wound infection in 1 case (3.8%) which required exploration, Obstruction of T tube in 1 case (3.8%) which required T tube canalization and emergent tracheostomy was performed in 1 case (3.8%). Postoperative evaluation of the anastomosis by contrast study, bronchoscopy, and upper GI endoscopy reveals no anastomosis leakage in all cases (100%), and the patient follow-up at 3 months and 1 year postoperatively reveals no recurrence of the fistula in all cases except 1 case (3.8%) which was dead from other causes and in another case, there were affected vocal cord movement but normal parenteral feeding and the voice was regained in low pitch. |