The multi-disciplinary management of complex congenital and acquired tracheo-oesophageal fistulae

Published on Jan 1, 2019in Pediatric Surgery International1.827
· DOI :10.1007/S00383-018-4380-8
Hemanshoo S. Thakkar3
Estimated H-index: 3
(GOSH: Great Ormond Street Hospital),
Richard Hewitt16
Estimated H-index: 16
(GOSH: Great Ormond Street Hospital)
+ 10 AuthorsP De Coppi18
Estimated H-index: 18
(GOSH: Great Ormond Street Hospital)
Aim of the study Complex tracheo-oesophageal fistulae (TOF) are rare congenital or acquired conditions in children. We discuss here a multidisciplinary (MDT) approach adopted over the past 5 years.
#1Hilde Krom (Boston Children's Hospital)H-Index: 5
#2Margot Visser (LUMC: Leiden University Medical Center)H-Index: 1
Last. Angelika Kindermann (UvA: University of Amsterdam)H-Index: 20
view all 11 authors...
Serious and fatal complications after button battery ingestion are increasing worldwide. The aim of this study is to describe serious complications after battery ingestion in children in the Netherlands. All pediatric gastroenterologists in the Netherlands performing upper endoscopies were asked to report all serious complications after battery ingestion in children (0–18 years) between 2008 and 2016 retrospectively. Sixteen serious complications were reported: death after massive bleeding throu...
#1Zafar Nazir (The Aga Khan University Hospital)H-Index: 14
#2Muhammad Arif Mateen Khan (The Aga Khan University Hospital)H-Index: 5
Last. Javaria Qamar (The Aga Khan University Hospital)H-Index: 2
view all 3 authors...
Abstract Objective Recurrent and acquired fistulae are a serious complication of congenital esophageal atresia and tracheoesophageal fistula (TEF) repair and foreign body ingestion (FBI) (e.g., button battery). We report our experience with a minimally invasive approach to recurrent and acquired TEF. Methods Medical records of patients referred for management of recurrent and acquired TEF between 2003 and 2015 were reviewed retrospectively. Patients underwent endoscopic procedures (de-epitheliza...
#1Jijun Wang (SJTU: Shanghai Jiao Tong University)H-Index: 27
#2Minzhong Zhang (SJTU: Shanghai Jiao Tong University)H-Index: 1
Last. Wei Cai (SJTU: Shanghai Jiao Tong University)H-Index: 27
view all 6 authors...
: Recurrent tracheoesophageal fistula (rTEF) is a complex complication after the repair of esophageal atresia (EA) and remains a challenge because of difficulties in preoperative management and the substantial rates of mortality and morbidity after reoperation. By reviewing a single institution's experience in the management of rTEF and assessing the outcome, we aimed to provide an optimal approach for managing rTEF and to evaluate growth and feeding problems after reoperations. The medical reco...
OBJECTIVES: Evaluation of complex, acquired, non-malignant tracheo/broncho-oesophageal fistulas (TEF) repaired by extrathoracic pedicled muscle flaps that were, in addition to their interposition between the airways and the gastro-intestinal tract, patched into gastro-intestinal or airway defects if primary closure seemed risky. METHODS: A single institution experience of patients treated between 2003 and 2015. Twenty-two patients required TEF repair following oesophageal surgery (18), Boerhaave...
#1C. Jason Smithers (Boston Children's Hospital)H-Index: 13
#2Thomas E. Hamilton (Boston Children's Hospital)H-Index: 24
Last. Russell W. Jennings (Boston Children's Hospital)H-Index: 54
view all 8 authors...
Abstract Purpose Recurrent trachea-esophageal fistula (recTEF) is a frequent (5%–10%) complication of congenital TEF (conTEF) and esophageal atresia (EA) repair. In addition, postoperative acquired TEF (acqTEF) can occur in addition to or even in the absence of prior conTEF in the setting of esophageal anastomotic complications. Reliable repair often proves difficult by endoluminal or standard surgical techniques. We present the results of an approach that reliably identifies the TEF and facilit...
#1Inna N. Lobeck (Cincinnati Children's Hospital Medical Center)H-Index: 7
#2Phylicia Dupree (Cincinnati Children's Hospital Medical Center)H-Index: 7
Last. Daniel von Allmen (Cincinnati Children's Hospital Medical Center)H-Index: 25
view all 6 authors...
Abstract Purpose Severe esophageal disease warranting replacement often presents with additional airway anomalies in children. Colon interposition and airway reconstruction have separately proven successful in attaining satisfactory outcomes. The aim of this study was to determine outcomes associated with an interdisciplinary approach to care of the patient with complex esophageal and airway disease. Methods After IRB approval, a retrospective cohort study was performed spanning 2011 through 201...
#1Hong-Li Wu (SDU: Shandong University)H-Index: 3
#2B.-X. Guan (SDU: Shandong University)H-Index: 1
Last. Jianqiang Guo (SDU: Shandong University)H-Index: 11
view all 9 authors...
Summary The aims of this study were to investigate intrapapillary capillary loops (IPCLs) of superficial esophageal lesions changes in different types classified by the Japan Esophageal Society classification. The calibers, areas, and densities of IPCLs were detected in 34 cases of esophageal lesions using immunohistochemical analysis. Statistically significant differences in calibers, areas, and densities of IPCLs were observed between type A, type B1/B2, and type B3 area (P < 0.001). In conclu...
#1Abhinav R. Ettyreddy (University of Pittsburgh)H-Index: 4
#2Matthew W. Georg (University of Pittsburgh)H-Index: 5
Last. Jeffrey P. Simons (University of Pittsburgh)H-Index: 17
view all 5 authors...
Children with a button battery impaction present with nonspecific symptoms that may account for a delay in medical care. We conducted a retrospective study of the clinical presentation, management, and complications associated with button battery ingestion in the pediatric aerodigestive tract and to evaluate the associated long-term morbidity. We reviewed the medical records of 23 patients who were treated for button battery impaction at our tertiary care children's hospital from Jan. 1, 2000, t...
: The use of extracorporeal membrane oxygenation (ECMO) for elective thoracic surgical procedures has been infrequently reported in the anaesthetic literature. We report the use of intraoperative veno-venous ECMO support for a patient with a previous left pneumonectomy who required a right-sided thoracotomy for repair of a tracheo-oesophageal fistula. To avoid traumatising or pressurising the fistula, a spontaneous ventilation technique was used prior to intubation with a single-lumen endotrache...
#1Matthew J. Provenzano (Cincinnati Children's Hospital Medical Center)H-Index: 2
#2Michael J. Rutter (Cincinnati Children's Hospital Medical Center)H-Index: 32
Last. Alessandro de Alarcon (Cincinnati Children's Hospital Medical Center)H-Index: 20
view all 8 authors...
Abstract Purpose The purpose of this study is to determine the surgical outcome of slide tracheoplasty for the treatment of tracheoesophageal (TE) fistula in pediatric patients. Methods After internal review board approval, the charts of pediatric patients (0–18years old) who had undergone slide tracheoplasty for tracheoesophageal fistula were retrospectively reviewed. Patient information and surgical outcomes were reviewed. Results Nine patients underwent slide tracheoplasty for correction of T...
Cited By7
Last. Vasili Averyn (Belarusian State Medical University)
view all 5 authors...
Background null Despite improvements in the treatment of esophageal atresia with tracheoesophageal fistula (TEF) in recent decades, complications still exist. The rate of fistula recanalization after surgical repair is ~5% in large cohorts. However, there is controversy regarding the gold standard of treatment. This research aimed to evaluate the efficacy of treatment of pediatric patients with isolated (H-type) and recurrent TEF in our clinic. null Methods null We retrospectively analyzed 12 pa...
#1Martin J. Elliott (UCL: University College London)H-Index: 68
#2Derek J. Roebuck (Boston Children's Hospital)H-Index: 2
Last. Clare A. McLaren (Boston Children's Hospital)H-Index: 1
view all 8 authors...
#1Minzhong Zhang (SJTU: Shanghai Jiao Tong University)
#2Yangwen Lin (SJTU: Shanghai Jiao Tong University)
Last. Jun Wang (SJTU: Shanghai Jiao Tong University)H-Index: 13
view all 8 authors...
Abstract Background & aims : Recurrent tracheoesophageal fistula (rTEF) after esophageal atresia requires complex management across different specialties. This study reviews our experience and discusses a multidisciplinary (MDT) approach adopted in the past 4 years. Methods : We reviewed the medical records of 100 patients with rTEF managed by an MDT approach (post-MDT group) from 2016 to 2019. These cases were compared to a historical group of 35 patients with rTEF from 2012 to 2015 (pre-MDT gr...
#1Anastassios C. Koumbourlis (GW: George Washington University)H-Index: 18
#2Yvonne Belessis (Boston Children's Hospital)H-Index: 12
Last. Thomas Kovesi (Children's Hospital of Eastern Ontario)H-Index: 19
view all 10 authors...
Tracheoesophageal fistula (TEF) with esophageal atresia (EA) is a common congenital anomaly that is associated with significant respiratory morbidity throughout life. The objective of this document is to provide a framework for the diagnosis and management of the respiratory complications that are associated with the condition. As there are no randomized controlled studies on the subject, a group of experts used a modification of the Rand Appropriateness Method to describe the various aspects of...
#1Eric P. Zhou (ISMMS: Icahn School of Medicine at Mount Sinai)
Tracheoesophageal fistulae (TEF) commonly occur as part of the vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal, and limb abnormalities (VACTERL) association. However, pulmonary agenesis is not typically seen with TEF. We report the anesthetic management of a TEF repair in a 33-week-old, 1.6-kg, monochorionic diamniotic twin with right lung agenesis, intrauterine growth restriction, and cardiac dextroposition. Due to the unique position of the heart, the patient...
#1Soichi Shibuya (Juntendo University)H-Index: 3
#2Takahiro Azuma (Juntendo University)
Last. Atsuyuki Yamataka (Juntendo University)H-Index: 32
view all 5 authors...
A 16-month-old boy was referred to our hospital for the management of suspected lithium button battery (LBB) ingestion. He had been previously well, but became febrile with a persistent cough resistant to oral antibiotics and dysphagia for 5 days. Radiography identified an LBB lodged in the upper esophagus. The LBB was retrieved under direct visualization with rigid laryngoscopy. He was sedated for 5 days and enteral feeding was commenced through a nasojejunal tube on the next day after procedur...
#1Ana Jové Blanco (Hospital General Universitario Gregorio Marañón)H-Index: 1
#2Ana Gutiérrez Vélez (Hospital General Universitario Gregorio Marañón)H-Index: 1
Last. Juan Luis Rodríguez Cimadevilla (Hospital General Universitario Gregorio Marañón)H-Index: 1
view all 6 authors...
OBJECTIVE: To describe the epidemiological characteristics, hospital follow-up, and course of patients who underwent surgery for esophageal atresia and its consequences on lung function. POPULATION AND METHODS: Retrospective, longitudinal, and analytical study. The medical records of patients with esophageal atresia born between 1996 and 2017 were reviewed. Perinatal data, type of atresia, associated malformations, respiratory and gastrointestinal complications, and spirometry data were recorded...
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