Document Detail


The diagnosis and management of recurrent tracheoesophageal fistulas.
MedLine Citation:
PMID:  20152347     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This review provides a blueprint to deal with the diagnosis and management of recurrent tracheoesophageal fistulas. METHODS: A retrospective review over 27 years found 26 recurrent tracheoesophageal fistulas. Descriptive statistical analyses were performed. RESULTS: In this cohort of 26 patients, 18 had a leak after their primary operation; and 22 had respiratory symptoms leading to the discovery of the recurrent fistula. The diagnosis was made by contrast study in 24. The repairs entailed placing a catheter through the fistula; separating the trachea and esophagus using sharp dissection; and placing tissue, preferably pericardium, between the suture lines. Postoperative complications included 7 anastamotic leaks, 4 strictures, and 3 recurrent fistulas. Long-term follow-up (median of 84 months) showed that 21 took all of their nutrition by mouth, 3 were tube fed, and 2 required a combination. Of the 23 patients with growth chart data, 16 fell in the first quartile of the growth chart, whereas none fell between the 75th and 100th percentile. CONCLUSION: This series, the largest to date, describes characteristics of recurrent tracheoesophageal fistulas, including techniques to make the diagnosis and provide a secure closure of the fistula, and the long-term outcomes of these patients.
Authors:
Steven W Bruch; Ronald B Hirschl; Arnold G Coran
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  45     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-15     Completed Date:  2010-04-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  337-40     Citation Subset:  IM    
Copyright Information:
Copyright 2010. Published by Elsevier Inc.
Affiliation:
Section of Pediatric Surgery, Department of Surgery, CS Mott Children's Hospital, University of Michigan, Ann Arbor, MI 48109-0245, USA. sbruch@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anastomosis, Surgical / methods
Child
Child, Preschool
Esophageal Atresia / diagnosis,  surgery
Esophageal Stenosis / diagnosis,  surgery
Esophagus / surgery
Female
Gastrostomy / methods
Humans
Infant
Infant, Newborn
Infant, Premature
Ligation / methods
Longitudinal Studies
Male
Outcome Assessment (Health Care)
Postoperative Complications / diagnosis,  surgery
Recurrence
Reoperation / methods
Trachea / surgery
Tracheoesophageal Fistula / diagnosis*,  surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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