Endoscopic Detection and Surgical Repair of Congenital Tracheo-Esophageal-Fistula (TEF) ± Esophageal Atresia (EA) - Open Journal of Pediatrics

OJPed > Vol.4 No.4, December 2014

Open Journal of Pediatrics

Volume 4, Issue 4 (December 2014)

ISSN Print: 2160-8741 ISSN Online: 2160-8776

Google-based Impact Factor: 0.45 Citations

Endoscopic Detection and Surgical Repair of Congenital Tracheo-Esophageal-Fistula (TEF) ± Esophageal Atresia (EA) ()

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Download as PDF (Size: 3346KB) PP. 283-290

DOI: 10.4236/ojped.2014.44039 5,094 Downloads 6,967 Views Citations

Author(s)

Ralf-Bodo Tröbs^1*, Werner Finke²

Affiliation(s)

¹Department of Pediatric Surgery, Marienhospital Herne, St. Elisabeth Group, Ruhr-University of Bochum, Herne, Germany.
²Department of Anesthesiology and Surgical Intensive Care, Marienhospital Herne, St. Elisabeth Group, Ruhr-University of Bochum, Herne, Germany.

ABSTRACT

Purpose: This study was performed to evaluate the management of tracheoesophageal fistula (TEF) ± esophageal atresia (EA) under the guidance of preoperative tracheo-bronchoscopy (TrSc). Methods: Between 2007 and July 2014, a total of 26 consecutive newborns who underwent rigid TrSc for suspected TEF were identified. All associated charts and operation reports were retrospectively analyzed. Results: Distal TEF with EA (Gross C) predominated (n = 18). Furthermore, we managed 2 infants with proximal and distal TEF (Gross D) and 4 infants with isolated TEF (Gross E). In our hands, TrSc was feasible in infants with a birth weight above 1300 g. Twenty-five fistulas were identified by endoscopy in 23 patients. In one infant with a birth weight below 1000 g, an attempt to perform TrSc was interrupted, and urgent TEF closure was required. Fistula site at the carina was associated with a high rate of esophageal anastomosis under tension. During surgery, proximal TEF and isolated TEF were safely approached via right cervicotomy (n =5). Conclusion: This study supports the routine use of rigid TrSc at the time of surgery. Rigid TrSc allowed the surgical team to identify the number and location of TEFs, and the incidence of side effects was low.

KEYWORDS

Tracheoesophageal Fistula, Esophageal Atresia, Tracheo-Bronchoscopy, Airway Management, Cervical Approach

Share and Cite:

Tröbs, R. and Finke, W. (2014) Endoscopic Detection and Surgical Repair of Congenital Tracheo-Esophageal-Fistula (TEF) ± Esophageal Atresia (EA). Open Journal of Pediatrics, 4, 283-290. doi: 10.4236/ojped.2014.44039.

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