Recurrent and acquired tracheoesophageal fistulae (TEF)-minimally invasive management.
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 3months to 3years (mean 1.5year) 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 7months to 10years (mean 4.2years).
CONCLUSIONS: Active observation and repeat combined endoscopic procedures are safe alternatives to open surgical repair of acquired and recurrent TEF.
LEVEL OF EVIDENCE: Level IV study.
Journal of Pediatric Surgery
(2017). Recurrent and acquired tracheoesophageal fistulae (TEF)-minimally invasive management.. Journal of Pediatric Surgery, 52(10), 1688-1690.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_paediatr/23