Tracheoesophageal fistulas are an uncommon problem. The fistulas — which are abnormal connections between the trachea and esophagus — occur as a result of complications from prolonged mechanical ventilation.  Patients must be weaned from mechanical ventilation before primary repair and reconstruction can be considered. 

This very difficult group of patients can achieve a high degree of success in re-instituting oral nutrition and eliminating dependence on tracheostomy tubes. 

In suitable patients, a single-stage repair has been developed to deal with this very difficult and challenging problem. 

Douglas J. Mathisen, MD

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