Recurrent and acquired tracheoesophageal fistulae (TEF): Minimally invasive management

Document Type



Surgery; Paediatric Surgery


Objective: Recurrent and acquired fistulae are a serious complication of congenital esophageal atresia and tracheoesophageal fistula (TEF) repair and foreign body ingestion (FBI) (e.g., button battery). We report our experience with a minimally invasive approach to recurrent and acquired TEF.
Methods: Medical records of patients referred for management of recurrent and acquired TEF between 2003 and 2015 were reviewed retrospectively. Patients underwent endoscopic procedures (de-epithelization of fistulous tract and fibrin tissue adhesive-TisseelR) under general anesthesia.
Results: Nine children (7 male, 2 female) with age range 3 months to 3 years (mean 1.5 year) were managed. TEF closed spontaneously in four patients, whereas in 5 patients the TEF closed after combined endoscopic procedure. Three patients required repeat endoscopic procedures. Follow-up ranged between 7 months to 10 years (mean 4.2 years).
Conclusions: Active observation and repeat combined endoscopic procedures are safe alternatives to open surgical repair of acquired and recurrent TEF.

Publication (Name of Journal)

Journal of Pediatric Surgery