Introduction:

The tracheoinnominate fistula, though a rare entity, is a potential life threat if it is not promptly recognized and treated.

Objective:

To analyze the influential factors in the results of tracheoinnominate fistula I.

Methods:

Retrospective study supported on the prospective databases from patients with tracheoinnominate fistulae, who had been treated from 1991 to 2013. They were classified according to their previous surgery: tracheostomy, use of a T-tube or re-interventions aimed at resecting the stenotic tracheal segment. The review of pathogeny and of diagnostic methods allowed a better understanding to face this severe complication. The factors that could have an impact on the results were also analyzed.

Results:

Four patients were women. Two patients had undergone tracheostomy; two had been reoperated after treatment with T-tube; resection and tracheal anastomosis were performed in one of them but these procedures were not possible to be applied to the other because of a punctiform tracheal lesion during the mediastinal dissection. A T-tube had been placed in this last patient through tracheofissure. The sentinel bleeding in two of three patients was not properly evaluated. In one of them, the bleeding was considered to be the result of anticoagulant treatment whereas in the other, the small amount of blood in the sputum was underassessed.

Conclusions:

High amount of suspicion, early diagnosis and application of bedside measures such as digital compression, placement of a T-tube or a tracheostomy cannula with overinflated cuff are the only hopeful options for these patients.

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