Heart, Lung and Circulation
How-To-Do-It| Volume 24, ISSUE 6, e75-e78, June 2015

Split Latissimus Dorsi Muscle Flap Repair of Acquired, Nonmalignant, Intrathoracic Tracheoesophageal and Bronchoesophageal Fistulas

Published:January 27, 2015DOI:
      The development of a fistula between the tracheobronchial tree and oesophagus due to nonmalignant causes is uncommon. Division of the fistula with muscle flap interposition eliminates contact between the tracheobronchial segment and the oesophagus, theoretically decreasing the chance of recurrence as well as providing a robust blood supply to aid in healing. The split latissimus dorsi muscle flap is a well-suited flap for such repairs because of the ability to simultaneously cover two separate apertures (tracheobronchial and oesophageal). The authors describe the split latissimus dorsi muscle flap with step-by-step technique for repair of intrathoracic aerodigestive fistulas.


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        • Arnold P.G.
        • Pairolero P.C.
        Intrathoracic muscle flaps. An account of their use in the management of 100 consecutive patients.
        Ann Surg. 1990; 211: 656-662
        • Tobin G.R.
        • Schusterman M.
        • Peterson G.H.
        • Nichols G.
        • Bland K.I.
        The intramuscular neurovascular anatomy of the latissimus dorsi muscle: the basis for splitting the flap.
        Plast Reconstr Surg. 1981; 67: 637-641
        • Tobin G.R.
        • Moberg A.W.
        • DuBou R.H.
        • Weiner L.J.
        • Bland K.I.
        The split latissimus dorsi myocutaneous flap.
        Ann Plast Surg. 1981; 7: 272-280
        • Heitmann C.
        • Guerra A.
        • Metzinger S.W.
        • Levin L.S.
        • Allen R.J.
        The thoracodorsal artery perforator (TDAP) flap – anatomical basis and clinical application.
        Ann Plast Surg. 2003; 51: 23-29
        • Mathisen D.J.
        • Grillo H.C.
        • Wain J.C.
        • Hilgenberg A.D.
        Management of acquired nonmalignant tracheoesophageal fistula.
        Ann Thorac Surg. 1991; 52: 759-765
        • Pool E.H.
        • Garlock J.H.
        A treatment of persistent bronchial fistula: an experimental and clinical study.
        Ann Surg. 1929; 90: 213-237