Surgical Management of Tracheocutaneous Fistula in Pediatric Population

Abstract

Introduction

Persistent tracheocutaneous fistula (TCF) is a complication of prolonged use of tracheostomy tube. Although many procedures exist to correct this issue, there is no consensus regarding its optimal management. We seek to review the outcome of TCF closure in pediatric population by primary closure and adjuvant application of fibrin glue.

Materials and Methods

Upon retrospectively reviewing our hospital’s records, we identified twelve children who underwent surgical repair of tracheocutaneous fistula through primary closure and adjuvant fibrin glue application between January 2019 and January 2023. We collected pertinent data related to their cases.

Results

We identified 7 male and 5 female patients. The mean duration of tracheostomy dependence was 19.52 months, and the mean time from decannulation to surgical closure was 9.29 months. All patients underwent primary closure with the adjuvant application of fibrin glue. There were no perioperative mortalities or morbidities, except for one patient who developed a minor wound infection.

Conclusions

The closure of a tracheocutaneous fistula by primary closure and application of fibrin glue is safe and effective and can allow for shorter hospital stays in children with persistent TCF.