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Criticality in tailoring the treatment for tracheoesophageal fistulas in children

  • M. B. Asik
  • I. Almre
  • L. Duchoud
  • K. SanduEmail author
Miscellaneous

Abstract

Objective

Tracheo-oesophageal fistula (TOF) is a rare pathology. It can be congenital and concurrent with other congenital anomalies such as oesophageal atresia, laryngeal and tracheal agenesis, or it can be acquired. The purpose of this study was to analyse various management strategies and their outcomes in infants and children with TOF and identify potential areas for standardisation of the fistula repair procedures.

Methods

At a single institution, a retrospective analysis of infants and children with congenital or acquired TOF between 2013 and 2019 was performed. Thirteen patients were identified. Data collection included: patient demography, associated congenital anomalies, details of fistula at the time of endoscopy, surgical approach and intra-operative findings, need for additional intervention(s), and outcomes.

Results

Thirteen patients underwent endoscopic or open surgeries for correction of TOF. The TOF was congenital in ten patients and acquired in three patients. Eight patients had associated aero-digestive comorbidities, and six patients had systemic comorbidities. Three patients underwent endoscopic procedures and nine patients underwent an open TOF repair. One patient had tracheal agenesis and was not offered any treatment. Two patients required multiple endoscopic interventions for recurrent TOFs. Among four patients with prior tracheostomy, three were decannulated and one awaits decannulation.

Conclusıon

Appropriate case selection and surgical ergonomics are essential for patients with TOF to avoid recurrences. Preoperative endoscopy to obtain precise details regarding associated laryngotracheal lesions and demographics of the fistula is crucial.

Keywords

Tracheoesophageal fistula Aero-digestive anomalies 

Notes

Author contribution

MBA was awarded a scholarship by the Turkish Society of Otorhinolaryngology and Head and Neck Surgery to visit the CHUV/Lausanne University Hospital, Switzerland and prepare the manuscript.

Compliance with ethical standards

Conflict of interest

None of the authors have any conflicts of interest.

Human and animal rights

Yes.

Informed consent

Yes.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology and Head and Neck SurgeryHealth Sciences University Gulhane Research and Training HospitalAnkaraTurkey
  2. 2.Department of Thoracic SurgeryChildren’s HospitalTallinnEstonia
  3. 3.Department of Otorhinolaryngology and Head and Neck SurgeryLausanne University Hospital, CHUVLausanneSwitzerland

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