ABSTRACT
According to the published data, the rate of fistula formation in the postoperative period ranges from 0.3% to 29%. Currently, due to the high risk of suture failure in the postoperative period and tracheal and esophageal fistulas formation, the options for fistulas treatment by the regenerative rehabilitation methods are under consideration. The frequency of fistula healing and reduction of scar deformities after adipose tissue autografting ranges from 43% to 55%. OBJECTIVE: To develop the minimally invasive technology for postoperative fistulas treatment and describe the real-world experience of its use in terms of hospital stay reduction and patients' quality of life improvement. MATERIAL AND METHODS: Patients were selected as part of a pilot research project (Development of Personalized Approaches to Regenerative Rehabilitation for Surgical Patients, # 0394-2020-0011). Patients' quality of life was assessed using the Russian version of the EQ-5D-5L questionnaire (Russian version for Russia). This article presents a clinical example of successful repair of a cutaneous tracheal fistula by autografting of adipose tissue three months after fistula formation. RESULTS: In one month after autografting of adipose tissue, the tracheobronchial secretion through the fistula has stopped. According to the follow-up computed tomography of the neck and tracheobronchoscopy, the fistulous passage is not observed. CONCLUSION: The presence of a fistula worsens the patient's quality of life and increases the risk of secondary infection. When treating patients with tracheal fistulas of high and extremely high surgical risk, the method of autografting of adipose tissue can be a safe and effective alternative to conventional surgery. Further study of this method of regenerative rehabilitation is required.
