• Journal of Chest Surgery
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• 제23권6호
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• pp.1275-1279
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• 1990

Esophagopleural fistula is a rare complication that should be suspected in all patients with recurrent empyema following pneumonectomy and in whom a bronchopleural fistula can be excluded. In late postpneumonectomy esophagopleural fistula, diagnosis is difficult due to its rarity and no specific symptom and sign, but we have experienced a man who had suffered dysphagia and odynophagia. In surgical treatment of late postpneumonectomy esophageal fistula, closure of empyema space is of prime importance. We have adopted a type of latissimus dorsi muscle and serratus anterior muscle flap transposition We present here this technique and result obtained in patient with late postpneumonectomy esophagopleural fistula.

• 대한치과의사협회지
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• 제41권7호통권410호
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• pp.504-508
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• 2003

This report demonstrates a case of tooth autotransplantation into the oroantral fistula site after extraction. Oroantral fistula can be developed when maxillary molar or premolar is extracted in case the root of tooth closed to or inside maxillary sinus. In most of cases, this would heal spontaneously without any interventions. Sometimes, many procedures including flap closure would be used judging from perforating size and previous inflammation. Although fistula size of this case is not that large, closure with tooth autotransplanted has successfully accomplished. So this report will discuss about several clinical aspects.

• Journal of Chest Surgery
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• 제45권4호
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• pp.260-262
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• 2012

Postpneumonectomy empyema is a life-threatening complication, which is often related with a bronchopleural fistula. After surgical repair of fistula, sterilization of infected pleural cavity is important and usually carried out by long-term cyclic irrigation. We report a case in which vacuum-assisted closure device was successfully applied to sterilize the pleural cavity and obliterate bronchopleural fistula.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권2호
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• pp.77-83
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• 2016

Objectives: To evaluate the effectiveness of regenerative tissue matrix (Alloderm) as an oral layer for difficult anterior palatal fistula closure. Materials and Methods: The authors have tested the feasibility of a novel surgical technique of adding a regenerative tissue matrix (Alloderm) as an oral layer for closure of recalcitrant large anterior palatal fistulae and report the outcome of the first 12 patients in this pilot study. Patients with recurrent large fistula who otherwise would require either a local pedicled flap, free flap, or an obturator were treated with this technique and followed up for at least 6 months to monitor the progress of healing. Results: Of the 12 patients, 8 patients (66.7%) had complete closure of the fistula, and 2 patients (16.7%) showed reduction in size of the fistula to the extent that symptoms were eliminated, for an overall success rate of 83.3% (10/12 patients). Premature graft loss and recurrence of the fistula were noted in 2 patients (16.7%). Conclusion: Alloderm provided an adequate barrier allowing healing to occur unimpeded and allowed closure of the palatal fistula. In our experience, this new technique using regenerative tissue matrix as an adjunct to the oral layer in large anterior palatal fistula has an advantage compared to other more invasive complex procedures and has been shown to provide satisfactory results.

• Archives of Plastic Surgery
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• 제49권5호
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• pp.617-632
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• 2022

Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure. A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed. Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1-13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1-43%), 7% (95% CI < 1-34%) for dermal graft interposition, < 1% (95% CI < 1-37%) for radial forearm free flap, < 1% (95% CI < 1-52%) for ligation of the fistula, 17% (95% CI < 1-64%) for interposition of a deltopectoral flap, 9% (95% CI < 1-28%) for primary closure, and 2% (95% CI < 1-20%) for interposition of a sternocleidomastoid muscle flap. Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.

• 대한기관식도과학회지
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• 제1권1호
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• pp.142-145
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• 1995

The tracheocutaneous fistula(TCF) may develop infrequently as a complication after tracheostomy. Prolonged tracheostomy tube dependence increases the risk of TCF developing, and in growth of stratified squamous epithelium lines the furrow connecting the tracheal mucosa and the skin, accounting for persistence of the fistulous tract. Such fistulas are a nuisance and create nursing and social problems including poor hygiene, aspiration, difficulty with speech, and depletion of pulmonary reserve. Surgical closure has generally been successful by primary closure, fistulectomy with primary closure, and closure by secondary intention following excision of the tracheocutaneous fistula. No large series compares the efficacy of these techniques and each has its own merits. Recent literature has purposed to minimizing complications. For ten years, from January 1985 to December 1994, the authors experienced 25 cases of TCF which were analyzed in respect to incidence and interval of cannulation, duration between decanulation and fistular closure, precedent disease, closure methods, and complications of TCF repair.

• Journal of Chest Surgery
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• 제23권3호
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• pp.566-571
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• 1990

The Bronchial stump disruption in bronchopleural fistula with empyema thoracis after pneumonectomy has remained one of the most dreaded complications of thoracic surgery. Management of chronic bronchopleural fistula still poses a therapeutic dilemma in spite of various surgical techniques that have been attempted to control this complication. Only recently, transsternal transpericardial approach for repair of the postpneumonectomy bronchopleural fistula has been utilized in some cases. The patient was a 31 year-old woman who was admitted to our hospital on August 18th, 1989 due to right postpneumonectomy bronchopleural fistula with empyema thoracis for 5 years since she had undergone right pneumonectomy due to pulmonary tuberculosis at E-hospital in 1984. Transsternal transpericardial closure of the fistula was employed and then the thoracic catheter was removed two months later, after the empyema cavity was sterilized by the Clagett method. So, we think this surgical technique is a relatively simple and effective method to the control of chronic postpneumonectomy bronchopleural fistula with empyema thoracis.

• Journal of Chest Surgery
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• 제30권6호
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• pp.636-640
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• 1997

기관 식도루의 발생은 대개 카프 주변의 압력에 의한 기관후벽의 궤양 및 괴사에 의한 식도와의 누공 발생에 의하여 생긴다. 본 교실에서는 23세의 여자 환자에서 심폐소생술을 위한 기관삽관후 12일째 발견한 기관식도루 1예를 치험 하였다. 기관식도루는 자연 치유가 드물어 수술로서 교정을 시행하여야 하며 진단 즉시 수술해야 하는 것이 원칙이나 본 예에서는 환자의 전신 상태가 쇠약하여 수술을 지연하였으며 기관 재건술후 재건 부위는 양호하였으나 위루관 제거부위 누출에 의한 복막염 및 패혈증으로 사망한 1예를 보고한다.

• 대한두개안면성형외과학회지
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• 제22권4호
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• pp.209-213
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• 2021

Primary palatoplasty for cleft palate places patients at high risk for scarring, altered vascularity, and persistent tension. Palatal fistulas are a challenging complication of primary palatoplasty that typically form around the hard palate-soft palate junction. Repairing palatal fistulas, particularly wide fistulas, is extremely difficult because there are not many choices for closure. However, a few techniques are commonly used to close the remaining fistula after primary palatoplasty. Herein, we report the revision of a palatal fistula using a pedicled buccal fat pad and palatal lengthening with a buccinator myomucosal flap and sphincter pharyngoplasty to treat a patient with a wide palatal fistula. Tension-free closure of the palatal fistula was achieved, as well as velopharyngeal insufficiency (VPI) correction. This surgical method enhanced healing, minimized palatal contracture and shortening, and reduced the risk of infection. The palate healed with mucosalization at 2 weeks, and no complications were noted after 4 years of follow-up. Therefore, these flaps should be considered as an option for closure of large oronasal fistulas and VPI correction in young patients with wide palatal defects and VPI.

• Journal of Chest Surgery
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• 제49권2호
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• pp.138-140
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• 2016

Broncho-pleural fistula (BPF) and esophago-pleural fistula (EPF) after pulmonary resection are challenging to manage. BPF is controlled by irrigation and sterilization, but such therapy is not sufficient to promote closure of EPF, which usually requires surgical management. However, it is generally difficult to select an appropriate surgical method for closure of BPF and EPF. Here, we report a case of concomitant BPF and EPF after left completion pneumonectomy, in which both fistulas were closed through a right thoracotomy.