Criticality in tailoring the treatment for tracheoesophageal fistulas in children

Aşık, Mehmet Burak; Almre, Ingemar; Duchoud, Lorry; Sandu, Kishore

doi:10.1007/s00405-019-05720-1

Cited by 2 publications

(3 citation statements)

References 20 publications

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“…Some authors 12 18 believe that open surgery is the treatment of choice for recurrent TEF, and others 20 consider endoscopy a preferable choice, particularly in cases of small and slender fistulas that are easily exposed. 16 It is believed by some that the endoscopic approach should be the first-line therapy for children with low birth weight and small isolated fistulae. 21 Small-sized fistulae (≤4 mm) have a higher probability of successful occlusion than large-sized fistulae.…”

Section: Discussionmentioning

confidence: 99%

“…As previously noted, some authors 3 12 20 believe that a few attempts are required for complete endoscopic fistula closure. A systematic review by Aworanti and Awadalla 12 reported successful single endoscopic treatments in 37% of patients, with the mean number of treatments required for complete closure being 2.1, whereas Asik et al 16 permitted two to three attempts of endoscopic treatment before switching to open surgery.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of isolated and recurrent tracheoesophageal fistula in children: a case series and literature review

Sautin

Marakhouski

Pataleta

et al. 2021

World Jnl Ped Surgery

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BackgroundDespite improvements in the treatment of esophageal atresia with tracheoesophageal fistula (TEF) in recent decades, complications still exist. The rate of fistula recanalization after surgical repair is ~5% in large cohorts. However, there is controversy regarding the gold standard of treatment. This research aimed to evaluate the efficacy of treatment of pediatric patients with isolated (H-type) and recurrent TEF in our clinic.MethodsWe retrospectively analyzed 12 patients (7 boys, 5 girls) aged 35 days–14.6 years. The median age of our patients was 632 days [95% CI (confident interval) 120.1 to 2118.7]; the mean birth weight was 2713 g (95% CI 2258 to 3169; median: 2763 g); and the mean gestational age was 37.1 weeks (95% CI 35.4 to 38.8; median: 37 weeks). All patients were managed for isolated or recurrent TEF between January 1, 2015 and December 31, 2020 using endoscopy (laser de-epithelialization).ResultsLaser de-epithelialization alone was effective in 8 of 12 patients (66.67%), with a mean number of de-epithelializations of 2.25 (range: 1–4). After one attempt at de-epithelialization, success was achieved in only two patients (n=16.67%). The mortality rate was 0%. The median follow-up for patients who received endoscopic treatment exclusively (n=8) was 3.7 years (95% CI 1.38 to 4.87) after the last stage of de-epithelialization.ConclusionFlexible endoscopy is an alternative treatment to open surgical repair of isolated and recurrent TEF in children. The effectiveness of endoscopic laser de-epithelialization alone with subsequent fistula obliteration was 66.7%, with a median follow-up of 3.7 years.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Treatment of isolated and recurrent tracheoesophageal fistula in children: a case series and literature review

Sautin

Marakhouski

Pataleta

et al. 2021

World Jnl Ped Surgery

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“…The incidence of congenital EA, with or without TEF, has been reported to be approximately 1 in 2500-4500 live births [1]. Corrective surgery such as open thoracotomy or thoracoscopic repair is the most commonly used modality for management [4].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Endoscopic Closure of Respiratory Esophageal Fistula in Children Using the Esophageal Approach: A Case Series

Lawati¹,

Saadah²,

Sajwani³

2022

Cureus

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Repository-esophageal fistula (REF) in children includes congenital or acquired tracheoesophageal fistula (TEF) and pleuro-esophageal fistula (PEF). TEF is a well-known congenital anomaly that is managed surgically. Recurrent tracheoesophageal fistula (rTEF) occurring after surgical repair of TEF is not an uncommon complication and most of the time requires repeat surgery.The aim of this paper is to report the outcomes of endoscopic closure of REF in children in Oman. This is a retrospective case series describing the endoscopic closure of REF in children in the Royal Hospital (RH), Oman. Five cases were identified with one of them having acquired PEF while the rest had rTEF. All children had esophageal endoscopic closure of the esophageal fistula using endoclips, cauterization, and glue injection. The patient who had PEF had successful closure of the fistula and only one out of four with rTEF had successful endoscopic closure.Esophageal endoscopic approach is unsatisfactory in the closure of rTEF but could be effective in the closure of inflammatory PEF. An esophageal approach for the closure of rTEF may need to be consolidated with simultaneous bronchoscopic closure.

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Criticality in tailoring the treatment for tracheoesophageal fistulas in children

Cited by 2 publications

References 20 publications

Treatment of isolated and recurrent tracheoesophageal fistula in children: a case series and literature review

Treatment of isolated and recurrent tracheoesophageal fistula in children: a case series and literature review

Outcomes of Endoscopic Closure of Respiratory Esophageal Fistula in Children Using the Esophageal Approach: A Case Series

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