Experience of diagnosis and treatment of 31 H-type tracheoesophageal fistula in a single clinical center

Pediatr Surg Int. 2018 Jul;34(7):715-719. doi: 10.1007/s00383-018-4293-6. Epub 2018 May 31.

Abstract

Objective: To summarize the experience of the diagnosis and treatment of 31 H-type tracheoesophageal fistula (TEF) at the Children's Hospital of Chongqing Medical University, Chongqing, China.

Methods: A total of 31 patients with H-type TEF were enrolled in this retrospective study from January 2000 to July 2017, and the diagnosis and treatment of the disease were analyzed and summarized.

Results: Iodine oil examination of the esophagus, fiberoptic bronchoscopy combined with esophagoscopy and three-dimensional computed tomography (3-D CT) reconstruction of the trachea and esophagus was used separately in 31 patients. 1 patient who had his TEF ligatured directly experienced recurrence 1 month after surgery, but recovered after TEF suturing. Subsequently, the remaining 30 patients were treated by suturing after TEF excision. All patients were followed up for 3 months-2 years and did not suffer from anastomosis orifice stenosis, gastroesophageal reflux, and a recurrent respiratory tract infection. Three patients exhibited vocal cord paralysis and improved spontaneously after a follow-up of 3-6 months.

Conclusion: H-type TEF is diagnosed by iodine oil examination of the esophagus, fiberoptic bronchoscopy combined with esophagoscopy, and 3-D CT reconstruction of the trachea and esophagus. Excision and suturing of the TEF separately are an effective treatment for the disease and are an excellent outcome.

Keywords: Diagnosis; Esophageal atresia; Experience; H-type tracheoesophageal fistula; Treatment.

MeSH terms

  • Anastomosis, Surgical
  • Child, Preschool
  • Esophagus / surgery
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Retrospective Studies
  • Trachea / surgery
  • Tracheoesophageal Fistula / classification
  • Tracheoesophageal Fistula / diagnosis*
  • Tracheoesophageal Fistula / surgery*