Anaesthesia for oesophageal atresia with or without tracheo-oesophageal atresia

Motshabi, Palesa

doi:10.1080/22201181.2014.979632

Cited by 3 publications

(7 citation statements)

References 51 publications

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“…This typically takes place within the first couple of days [ 23 ]. The failure to identify and ligate the fistula early leads to gastric distention, hypoventilation, hypoxia, cardiac compromise and death [ 3 , 13 ]. In our cohort, there was delayed presentation for surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The oesophagus ends blindly as a pouch, either in the neck or the thorax, and an abnormal communication between the trachea and the oesophagus often exists [ 2 ]. The incidence of TOF occurs in 1:3000–5000 live births globally [ 3 , 4 ]. There is a 30–50% incidence of associated congenital defects, including vertebral anomalies, anal atresia, congenital heart disease (CHD) and renal and limb anomalies (VACTERL) in neonates with OA and TOF [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…There is a 30–50% incidence of associated congenital defects, including vertebral anomalies, anal atresia, congenital heart disease (CHD) and renal and limb anomalies (VACTERL) in neonates with OA and TOF [ 2 ]. Cardiac lesions are said to occur in 20% of neonates, while vertebral, anal, renal and limb anomalies occur in 17%, 12%, 16% and 10%, respectively [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Type A/II is the second-most prevalent, with 7% of all cases. Type A/II are more complicated, usually requiring correction in stages, taking longer to repair and having higher complication rates compared to type C/IIIb [ 3 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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The Phenotypical Profile and Outcomes of Neonates with Congenital Tracheoesophageal Fistula Associated with Congenital Cardiac Anomalies Presenting for Surgery

et al. 2022

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(1) Background: Neonates born with oesophageal atresia and/or tracheooesophageal fistula (OA/TOF) are usually born with a multitude of other congenital anomalies, which may affect their anaesthetic care and survival to hospital discharge. We reviewed the profile and outcome of neonates with OA/TOF and associated congenital cardiac anomalies presenting for surgery at an academic hospital in South Africa. (2) Methods: A retrospective, cross-sectional analysis of all medical records of neonates who had undergone surgical repair of OA/TOF was conducted at an academic hospital between January 2015 and December 2019. Descriptive statistics were used to report the data. Comparisons in perioperative events and outcomes between those with cardiac lesions and those without were done. (3) Results: Neonates presenting for OA/TOF repair with congenital cardiac defects had an incidence of 62 [95% CI 38.5–99.8] per 1000 days since birth. In total, 45.9% had associated cardiac anomalies, with PDA and ASD as the most prevalent lesions. There were statistically significant differences in intraoperative adverse events seen in neonates with congenital cardiac lesions as compared to those without. (4) Conclusion: Despite advances in neonatal critical care and anaesthetic and surgical techniques, OA/TOF associated with congenital cardiac anomalies is still associated with high mortality rates in developing countries.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Phenotypical Profile and Outcomes of Neonates with Congenital Tracheoesophageal Fistula Associated with Congenital Cardiac Anomalies Presenting for Surgery

et al. 2022

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“…On plain chest and abdominal radiographs, the tip of the catheter can appear curled up at the chest or upper neck level. Gas in the stomach and intestines can be found in some cases, suggesting distal TEF[ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Accidental esophageal intubation via a large type C congenital tracheoesophageal fistula: A case report

Hwang¹,

Kim²,

Kim³

2022

World J Clin Cases

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BACKGROUND Tracheoesophageal fistula (TEF) is a congenital anomaly characterized by interruptions in esophageal continuity with or without fistulous communication to the trachea. Anesthetic management during TEF repair is challenging because of the difficulty of perioperative airway management. It is important to determine the appropriate position of the endotracheal tube (ETT) for proper ventilation and to prevent excessive gastric dilatation. Therefore, the tip of the ETT should be placed immediately below the fistula and above the carina. CASE SUMMARY A full-term, one-day-old, 2.4 kg, 50 cm male neonate was diagnosed with TEF type C. During induction, an ETT was inserted using video laryngoscope and advanced deeply to ensure that the tip passed over the fistula, according to known strategies. The passage of the ETT through the vocal cords was confirmed via video laryngoscope. However, after inflating the ETT cuff, breath sounds were not heard on bilateral lung auscultation. Instead, gastric sounds were heard. Considering that a large fistula (approximately 6.60 mm × 4.54 mm) located 10.2 mm above the carina was confirmed on preoperative tracheal computed tomography, the possibility of unintentional esophageal intubation was highly suspected. Therefore, we decided to uncuff and withdraw the ETT carefully for repositioning, while monitoring auscultation and end-tidal CO 2 simultaneously. At a certain point (9.5 cm from the lip), clear breath sounds and proper end-tidal CO 2 readings were suddenly achieved, and adequate ventilation was possible. CONCLUSION Preanesthetic anatomical evaluation with imaging studies in TEF is necessary to minimize complications related to airway management.

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Esophageal atresia with tracheoesophageal fistula: two case reports

Mwamanenge,

Mariki,

Mpayo

et al. 2023

J Med Case Reports

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Background The incidence of esophageal atresia with tracheoesophageal fistula is 1 out of 3000–5000 live births. Its incidence in lower middle income countries is not known. The infants usually present with excessive secretions or choking while feeding and are at risk for aspiration. The outcome of these infants in lower middle income countries is not encouraging due to delays in referral, sepsis at presentation requiring preoperative stabilization, postoperative complications such as anastomosis leaks, pneumonia, and pneumothorax. Case presentation We present two African babies who were term infants at age 2 days (male) and 5 days (female) with diagnosis of esophageal atresia and tracheoesophageal fistula. The 5-day-old infant required preoperative stabilization due to sepsis and delayed surgery with a poor postoperative outcome. The 2-day-old infant was preoperatively stable and had a good postoperative outcome. The challenges faced in management of these two cases have been highlighted. Conclusion Outcome of infants with esophageal atresia and tracheoesophageal fistula in lower middle income countries is not encouraging due to delays in referral and poor postoperative healing attributed to sepsis and recurrent pneumothorax. Timely referral, preoperative condition of the infant, and timely management has shown to be a contributory factor for an improved outcome.

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Anaesthesia for oesophageal atresia with or without tracheo-oesophageal atresia

Cited by 3 publications

References 51 publications

The Phenotypical Profile and Outcomes of Neonates with Congenital Tracheoesophageal Fistula Associated with Congenital Cardiac Anomalies Presenting for Surgery

The Phenotypical Profile and Outcomes of Neonates with Congenital Tracheoesophageal Fistula Associated with Congenital Cardiac Anomalies Presenting for Surgery

Accidental esophageal intubation via a large type C congenital tracheoesophageal fistula: A case report

Esophageal atresia with tracheoesophageal fistula: two case reports

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