Usefulness of large pleural flap for the treatment of children with recurrent tracheoesophageal fistula

Abstract

Large vascularized PF to closure RTF is a highly effective and physiologic method for preventing second recurrences.

Multiple anastomotic complications following repair of oesophageal atresia with tracheoesophageal fistula: A report of two cases

“…[21] In a study of 26 cases of recurrent TEF managed by open surgery, postoperative complications included seven anastomotic leaks, four strictures, and three recurrent fistulas. [19] A variety of techniques have been used to reduce the incidence of recurrent TEF including the interposition of pleura, azygos vein, and vascularized pericardial flaps between the trachea and oesophagus and avoiding damage to the distal oesophagus [4,13,19] Interposition of a pericardial flap has been suggested as the most appropriate surgical procedure, and was successfully used by us in one patient. [19,21] In recent years, successful endoscopic management of recurrent TEF, using fibrin glue (Tissel with added aprotinin) with diathermy, or argon plasma coagulation has been reported.…”

“…The incidence of recurrent TEF has been reported to be about 10% in most series. [11][12][13] The true incidence may even be greater because of difficulty in establishing the diagnosis. [12] Jain, et al: Anastomotic complications after oesophageal atresia repair Various factors have been implicated in the formation of recurrent TEF.…”

Thoracoscopic recurrent tracheo-oesophageal fistula repair with mini endostapler: promising solution

“…Postoperative adhesions complicate reoperations and may interfere with the dissection, which may lead to damage of the oesophageal and tracheal tissues 3. The separation of the suture lines seems to prevent leaks and recurrent TEF 9. Pleural, mediastinal tissue, muscle, intercostal or pericardial flaps have been employed in these cases 2.…”

Recurrent Tracheoesophageal Fistula and Respiratory Failure: The Role of Early Airway Endoscopic Approach

“…it consists of a complex procedure with high incidence of recurrence, and it requires preoperative evaluation, planning, and preparation to optimize results. 4 Most infants with rTEF usually present with symptoms (coughing, wheezing, respiratory distress, cyanosis while feeding) hardly distinguishable from those due to tracheomalacia or gastroesophageal reflux, which commonly develop after EA and TEF repair. The occurrence of acute respiratory failure due to both bowel distention and lung inflammation is really uncommon: definitely, radiographic assessment and airway endoscopy represent sequential diagnostic tools.…”