Esophageal Atresia with Double Tracheoesophageal Fistula

Passi, Yuvesh; Sampathi, Venkata; Pierre, Joelle; Caty, Michael G.; Lerman, Jerrold

doi:10.1097/aln.0b013e3182715ee6

Cited by 7 publications

(5 citation statements)

References 1 publication

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“…With the development of thoracoscopy technology, an increasing number of pediatric surgeons have started using the thoracoscopic approach to treat EA/TEF, which has the advantages of minimal invasiveness and adequate visualization 12,13,23–26 . However, studies on the surgical treatment of type D EA/TEF with a definite preoperative diagnosis are lacking 9–11 . Some researchers believe that for EA/TEF with a preoperative diagnosis of type C, proximal TEF should be highly suspected in cases when a large amount of gas leaks from the proximal esophagus during intraoperative esophageal anastomosis 16 .…”

Section: Discussionmentioning

confidence: 99%

“… 12 , 13 , 23 , 24 , 25 , 26 However, studies on the surgical treatment of type D EA/TEF with a definite preoperative diagnosis are lacking. 9 , 10 , 11 Some researchers believe that for EA/TEF with a preoperative diagnosis of type C, proximal TEF should be highly suspected in cases when a large amount of gas leaks from the proximal esophagus during intraoperative esophageal anastomosis. 16 In half of the patients in this study, proximal TEF was found intraoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…Only a few articles have reported this rare anomaly 6–8 . Most studies on the condition, management, and outcomes of type D EA/TEF are published in the form of case reports 9–11 . As the incidence of type D EA/TEF is low, most institutions lack clinical, diagnostic, and treatment experiences.…”

Section: Introductionmentioning

confidence: 99%

“… 6 , 7 , 8 Most studies on the condition, management, and outcomes of type D EA/TEF are published in the form of case reports. 9 , 10 , 11 As the incidence of type D EA/TEF is low, most institutions lack clinical, diagnostic, and treatment experiences. Therefore, we aimed to evaluate effective diagnostic and treatment strategies for type D EA/TEF by retrospectively analyzing the clinical characteristics and management of affected patients admitted to our center.…”

Section: Introductionmentioning

confidence: 99%

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Diagnose and treatment for Type D congenital esophageal atresia with tracheoesophageal fistula

Wang,

Zhao,

Zhang

et al. 2024

Pediatric Investigation

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ImportanceType D esophageal atresia (EA) with tracheoesophageal fistula (TEF) is characterized by EA with both proximal and distal TEFs. It is a rare congenital anomaly with a very low incidence.ObjectiveTo investigate diagnostic and treatment strategies for this rare condition.MethodsWe retrospectively reviewed the clinicopathological features of patients with EA/TEF treated at our institution between January 2007 and September 2021.ResultsAmong 386 patients with EA/TEF, 14 (3.6%) had type D EA/TEF. Only two patients were diagnosed with proximal TEF preoperatively. Seven patients were diagnosed intraoperatively. Five patients were missed for diagnosis during the initial surgery but was later confirmed by bronchoscopy. During the neonatal period, seven patients underwent a one‐stage repair of proximal and distal TEF via thoracoscopy or thoracotomy. Due to missed diagnosis and other reasons, the other 7 patients underwent two‐stage surgery for repair of the proximal TEF, including cervical incision and thoracoscopy. Ten of the 14 patients experienced postoperative complications including anastomotic leakage, pneumothorax, esophageal stricture, and recurrence. Patients who underwent one‐stage repair of distal and proximal TEF during the neonatal period showed a higher incidence of anastomotic leak (4/7). In contrast, only one of seven patients with two‐stage repair of the proximal TEF developed an anastomotic leak.InterpretationType D EA/TEF is a rare condition, and proximal TEFs are easily missed. Bronchoscopy may aim to diagnose and determine the correct surgical approach. A cervical approach may be more suitable for repairing the proximal TEF.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnose and treatment for Type D congenital esophageal atresia with tracheoesophageal fistula

Wang,

Zhao,

Zhang

et al. 2024

Pediatric Investigation

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show abstract

“…An esophagoscopy or bronchoscopy is often performed at the start of surgery to provide absolute confi rmation of the diagnosis, to assess the position of the fi stula if present, and to exclude multiple fi stulae [ 86 ]. A variety of techniques have been described to identify fi stulae in neonates: rigid bronchoscopy, esophagoscopy, or fl exible fi beroptic bronchoscopy via the tracheal tube.…”

Section: Surgical Considerationsmentioning

confidence: 99%