Median sternotomy and use of a pedicled sternocleidomastoid muscle flap in the management of recurrent tracheoesophageal fistula

Endoscopic management of recurrent congenital tracheoesophageal fistula: A review of techniques and results

“…There are also case reports using a variety of interposing tissue [2,8,12,13,15]. Including this report, 62 patients having endoscopic repair of congenital TEF are reported in literature [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] (Table 2). The overall success rate with various techniques was 60% with a mean number of 2.1 procedures per patient.…”

“…Since then, many reports have described a variety of techniques and obliterating agents ( Table 2). The morbidity from endoscopic repair is minimal to none [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. Our study reports two of three successful closures with bronchoscopic application of fibrin glue.…”

“…Nevertheless, a second open repair for recurrent fistula is technically challenging and has an associated high morbidity including a 10-22% incidence of a second recurrent fistula [2,4,8,13]. Re-operation with esophageal replacement or interposing various tissues such as pericardium, muscle, or pleura has been recommended to prevent recurrence [4,5,12,15]. Esophageal replacement is the only method that has been used extensively and it has a complication rate of greater than 60% [1,4,5].…”

Closure of a Cervical H-Type Tracheoesophageal Fistula

“…Surgical management of congenital cervical H-type TEF has not often been described in the literature [2]. The essential surgical procedures for H-type TEF must consist of identifying, sectioning, and suturing the fistula, and interposing the muscle [2,3]. Previously, identification of the fistula was difficult and special techniques, such as insertion of a guide wire [2] or balloon catheter across the fistula, and a large incision were considered necessary.…”

Management of Recurrent Tracheoesophageal Fistulas: A Systematic Review

“…4,[34][35][36][37] Some have used a left extrapleural approach, 38 a transcervical transtracheal approach, 39 or via a median sternotomy. 40 Many authors recommend placement of an interposition tissue between the sutured ends of the esophagus and trachea to prevent a second recurrence; these include mediastinal pleura, [41][42][43][44][45] vascularized pedicle of pericardium, 31,32,46 pedicled sternocleidomastoid flap, 40 coastal cartilage graft, 47 and omental flaps. 48 The postoperative care is similar to after an ET.…”