Intercostal pedicled flap in esophageal atresia

Soriano, Arturo; Hernández-Siverio, N; Carrillo, Ángel; A, Alarco Hernández; Hermoso, F. González

doi:10.1016/s0022-3468(87)80423-2

Cited by 10 publications

(4 citation statements)

References 9 publications

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“…RTEF, recurrent tracheoesophageal fistula. as intercostal (11), latissimus dorsi (12), and sternothyroid (13) muscles. The pleural patch (5, 7) and fascia lata graft (14) are useful for RTEF; however, in hindsight, a vascularized flap could have been more effective for the second RTEF in this case.…”

Section: Discussionmentioning

confidence: 99%

“…RTEF is commonly repaired by interposing a vascularized flap between the TEF repair site and the esophagus. Such vascularized flaps include the pericardium, pleura ( 5 , 7 ), omentum ( 10 ), and muscles, such as intercostal ( 11 ), latissimus dorsi ( 12 ), and sternothyroid ( 13 ) muscles. The pleural patch ( 5 , 7 ) and fascia lata graft ( 14 ) are useful for RTEF; however, in hindsight, a vascularized flap could have been more effective for the second RTEF in this case.…”

Section: Discussionmentioning

confidence: 99%

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Refractory tracheoesophageal fistula treated using multi-stage surgery: A case report

et al. 2022

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A tracheoesophageal fistula (TEF) recurs in approximately 2%–13% of cases of esophageal atresia with TEF that are treated surgically. Currently, there is no consensus on the most effective treatment to prevent recurrent TEF (RTEF). Herein, we present a patient with type C esophageal atresia who underwent thoracoscopic esophago-esophageal anastomosis and TEF repair at 2 days old. However, RTEFs were observed at ages 3, 6, and 11 months, and thoracoscopic TEF repairs using a pleural patch, fascia lata graft, and pectoralis major myocutaneous (PMMC) flap were performed, respectively. A fourth recurrence led to mediastinitis, shock liver, disseminated intravascular coagulopathy, and a compromised respiratory status. Hence, laparoscopic esophageal transection was first performed to improve the respiratory condition by preventing the regurgitation of gastric contents. Once the patient was stable, a subtotal esophageal resection with TEF closure followed by gastric tube reconstruction was performed. In conclusion, we encountered a case of refractory RTEF that was repaired four times using various techniques, including a fascia lata graft and PMMC flap. However, TEF still recurred after these four operations. The final surgical strategy involved an esophageal transection as a palliative therapy, which improved the respiratory condition, followed by closure of the TEF and subtotal esophageal resection. Finally, esophageal reconstruction using a gastric tube after the complete remission of inflammation was effective. This multi-stage surgery was considered the only choice to rescue the patient and effectively prevent another recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Refractory tracheoesophageal fistula treated using multi-stage surgery: A case report

et al. 2022

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“…Only a few cases were treated by insertion of a tracheal stent 17 or with a combination of esophageal and tracheal stents 16,22 . If the defect is limited, the application of muscle flaps, 23 such as the latissimus dorsi, 12 pectoralis major 24 and the intracostal muscles, 25 is feasible. For reconstruction of a massive tracheal defect, allograft 26 or a substitutional trachea 27 may considered as therapeutic options.…”

Section: Discussionmentioning

confidence: 99%

Salvage of a massive esophago-tracheal fistula resulting from a stenting treatment

Shichinohe¹,

Okushiba²,

Morikawa³

et al. 2006

Diseases of the Esophagus

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We report the successful surgical resolution of a case of massive esophago-tracheal fistula (ETF) caused by a stenting treatment for stricture of an esophago-gastric anastomosis. A 54-year-old man was admitted to our hospital due to serious pneumonia secondary to ETF. He had previously received esophagectomy and post-operative chemo-radiation therapy for esophageal cancer, followed by stenting treatments for a benign stricture of the esophago-gastric anastomosis. For surgical treatment of the resulting ETF, serial operations were required. The first operation, performed under percutaneous cardiopulmonary support, included removal of the stents followed by tracheotomy, were with the coverage of the tracheal defect achieved using both major pectoral muscle flaps. A salivary fistula was also generated and an enteral nutrition tube was placed. Six months after the first operation, a pedicled ileocolic interposition was performed in order to effect reconstruction of the digestive tube, with an additional microvascular anastomosis of the ileocolic and internal thoracic artery and vein. After the second operation, the patient's ability to ingest food was restored, and he was discharged from the hospital. Thus, ETF was successfully treated by successive surgical operations with delicate intra- and post-operative respiratory management.

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“…Δεν πρέπει να παραγνωρίζουμε την πιθανότητα ύπαρξης δεύτερου η και τρίτου ΤΟΣ, γι αυτό η παρασκευή του οισοφάγου πρέπει να γίνεται όσο το δυνατόν σε μεγαλύτερη έκταση (205). Για την αποφυγή υποτροπής του συριγγίου μπορεί να παρεμβληθεί κρημνός από μυ ή από υπεζωκότα ή να τοποθετηθεί μόσχευμα λυοφιλοποιημένης σκληρής μήνιγγας (Lyodura) μεταξύ του οισοφάγου και της τραχείας (23,96,181). Επίσης μπορεί να τοποθετηθούν μία ή δύο ραφές μεταξύ του οισοφάγου και της προσπονδυλικής περιτονίας έτσι ώστε ο οισοφάγος να στραφεί κατά ενενήντα μοίρες και να μην εφάπτονται τα σημεία συρραφής με την τραχεία (159).…”

Section: ατρησία οισοφάγου με μεγάλο χάσμαunclassified

Ατρησιες Οισοφαγου Και Τραχειοοισοφαγικα Συριγγια

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Intercostal pedicled flap in esophageal atresia

Cited by 10 publications

References 9 publications

Refractory tracheoesophageal fistula treated using multi-stage surgery: A case report

Refractory tracheoesophageal fistula treated using multi-stage surgery: A case report

Salvage of a massive esophago-tracheal fistula resulting from a stenting treatment

Ατρησιες Οισοφαγου Και Τραχειοοισοφαγικα Συριγγια

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