connected to a nasogastric tube that continuously removes secretions. Complete closure is achieved by inducing granulation tissue at thestula. The authors suggested that endoscopic vacuum-assisted closure with a sponge might be an adequate alternative treatment option for esophageal stenting for esophagotracheal s- tula after esophagectomy.

•\ AlloDerm, an acellular dermal matrix derived from donated human skin tissue, used for tissue reconstruction, has been used to treat a 4 cm stulous tract developed after a lower right lobectomy. AlloDerm was used during the surgical procedure to reconstruct the membranous trachea, close the esophageal defect primarily, and interpose a muscle fap. The procedure was successful in completely closing the stula, suggesting that AlloDerm can be a useful tool for complex airway reconstructions when options are limited [77].

Summary andRecommendations

Aero-digestive stulas represent complex clinical situations. When they are congenital or result from benign conditions, surgical treatment with curative intent is the procedure of choice. Some other procedures can be applied as well, but they have to be evaluated personalized to the patient, taking into consideration his/her desires, clinical status, comorbidities, and possibilities for success (risk/bene t assessment), and discussed in a multidisciplinary team.

In malignant ADF, chances for long-term success are almost null, and the main focus should be palliation of symptoms and quality of life. In that respect, preserving nutrition status and avoiding aspiration and respiratory infections are priorities. To achieve the best palliation goals, many methods are available.

We cannot overemphasize the need of a multidisciplinary approach, where a careful risk/bene-t assessment is considered. Patient’s wishes should be respected and included in any therapeutic decision.

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M. Simoff (*)

Department of Pulmonary & Critical Care Medicine, Bronchoscopy and Interventional Pulmonology, Henry Ford Hospital, Wayne State University, Detroit, MI, USA

e-mail: Msimoff1@hfhs.org

H. Bedi

Stanford University, Stanford, CA, USA e-mail: hbedi@stanford.edu

B. Eperjesiova

University of Florida, Health Shands Hospital System and VA, Gainesville, FL, USA

Airway foreign body (FB) aspiration is defned by the presence of foreign material anywhere in the glottis and/or tracheobronchial tree, with or without air ow obstruction. One cannot discuss FB retrieval without mentioning the birth of interventional pulmonology (IP) and its pioneers. On March 30, 1897, using illuminated rigid esophagoscope with a mirror and rigid forceps, Dr. Gustav Killian performed the frst documented FB retrieval from the right mainstem bronchus of a German farmer who had aspirated a small piece of pork bone while eating a soup [1]. This event marks the beginning of bronchoscopy and IP with Dr. Killian identifed as the “Father of Bronchoscopy.”

The frst FB retrieval performed in the USA was at Massachusetts General Hospital by Algernon Coolidge in 1898. Dr. Chevalier Jackson, following in Dr. Killian’s footsteps, continued to advance the technique of bronchoesophagoscopy and developed various instruments, including the frst illuminating bronchoscope. For his work, he is credited as “Father of American Bronchoesophagology.” Like Gustav Killian, he was a renowned otolaryngologist. His collection of over 2000 foreign bodies that he retrieved over his career is still on display at the Mütter Museum in Philadelphia, Pennsylvania (USA).