METHOD OF SURGICAL TREATMENT OF TRACHEOOESOPHAGEAL FISTULA COMBINED WITH TRACHEAL STENOSIS

摘要

FIELD: medicine.;SUBSTANCE: substance of a method consists in intraoperative visualiSation of a fistula, circular excision of a mucosa within said fistula and closure of defects of an oesophageal and tracheal wall. At the first stage, tracheoplastic tracheostomy is conducted, and a T-shaped tracheal endoprosthesis is inserted. At the second stage, epithelisation of an edge of tracheostoma is followed with closing a tracheoesophageal fistula. For this purpose, the T-shaped tracheal endoprosthesis is removed, and a tracheal end of the tracheoesophageal fistula is excised circularly through an opening of the tracheoplastic tracheostomy. Then, a purse-string suture is applied on the exposed oesophageal mucosa, tightened with the oesophageal mucosa being embedded in an oesophageal lumen, thereafter, extramucous layers of the oesophagus and trachea are sutured, and a defect of the tracheal wall is closed with single sutured through the opening of the tracheoplastic tracheostomy.;EFFECT: use of the given invention allows to reduce a number of intraoperative injures, to eliminate pathological communication between the oesophagus and trachea, to preserve blood supply of oesophageal and tracheal walls in an operated region, to avoid mediastinitis in case of lack of the sutures applied on the organ walls within the fistula, to prevent narrowing of the oesophagus and trachea within the applied sutures.;1 ex, 3 dwg