[On the surgery of esophago- tracheal fistulae (author's transl)].

Esophago-tracheal fistulae develop to an increasing extent due to the long-term intubation in intensive-care patients. Their treatment is usually problematic, since the general condition of the patient, weakened by his basic disease, very often does not permit any major intervention; in addition, the topographical location of the fistula makes the access to it even more difficult. In one patient two attempts failed to close the fistula from an extended tracheostomy. The narrow access passage between the anaesthetic tube and the tracheal wall did not permit an exact suture; the heavy formation of scars in the fistular environment did not permit either a preparation in layers or the shift of mucosal flaps for coverage. However, a fistula was successfully closed from a collar mediastinotomy. With normal tracheal width, unrestricted esophagus function was restored without damage to the recurrent laryngeal nerve. The advantages of this surgical method are discussed in greater detail.