A procedure for management of acquired tracheoesophageal fistula in ventilator patients.

An operative technique is presented for acquired tracheosophageal fistula including cervical esophagostomy, division and closure of the distal esophagus, and use of the cervical and thoracic esophageal segment as a patch to close the posterior trachea wall. Later coloesophagoplasty is used to establish gastrointestinal continuity. An external negative-pressure ventilator (Drinker-Collins iron lung) is used in combination with a conventional positive-pressure ventilator to diminish airway pressure after the tracheal repair.