To evaluate the efficacy of surgical repair of mechanical ventilation-related tracheoesophageal fistula (TEF) .

Patients who underwent surgical treatment of TEF associated with mechanical ventilation from January 2019 to December 2023 in Shanghai Chest Hospital were collected, followed by a retrospective analysis of the efficacy of different surgical repair approaches.

Sixteen patients who experienced TEF associated with mechanical ventilation were included in this study, including 5 repaired by tracheal resection anastomosis, among which 1 had muscle flap isolation placed between the tracheoesophagus, 1 suffered stenosis and atresia above and below the glottis due to chemical injury and received permanent tracheostomy, and the others experienced no complications such as recurrent laryngeal nerve injury or anastomotic hiatus. Among them, 10 patients were repaired through lateral approach repair, 2 were implanted with muscle flap packing and isolation, and all patients experienced no complications such as recurrent laryngeal nerve injury or anastomotic dehiscence. Meanwhile, 1 patient was confirmed with satisfactory healing of the anastomotic area by bronchoscopy and esophagoscopy 2 weeks postoperatively but died of respiratory and circulatory failure due to carbon dioxide retention, and rejected intubation by family members. One patient underwent gastric esophageal bypass surgery, with intraoperative investigation indicating a large fistula that could not be repaired directly. Additionally, postoperative anastomotic leakage occurred and recovered through conservative treatment. Moreover, airway collapse combined with dyspnea occurred after removal of the pneumonectomy cannula, followed by the placement of permanent silicone stent.

Tracheal resection anastomosis and lateral approach repair are both effective in curing TEF associated with mechanical ventilation. In the meantime, bypass surgery is suitable for patients with large fistulas that cannot be repaired directly.